https://doi.org/10.4081/ecj.2021.9548
An unusual case of neck hematoma and hypercalcemia
Submitted: 4 December 2020
Accepted: 27 May 2021
Published: 21 September 2021
Accepted: 27 May 2021
Abstract Views: 1033
PDF: 214
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
One of the most frequent cause of hypercalcemia is primary hyperparathyroidism, which can lead to systemic involvement and life-threatening conditions. We described a rare case of a parathyroid adenoma rupture with consequent bleeding and respiratory airway compression. An 84-year-old man presented to the emergency department complaining neck swelling and related dysphagia. A computer tomography of the neck revealed an extensive left lateral hematoma, and a neck ultrasonography evidenced a hemorrhagic parathyroid adenoma, later confirmed by a 99 mTc-MIBI scintigraphy. To date only 40 cases of ruptured parathyroid adenomas have been described in literature, however due to the possibility of massive bleeding and compression of the airways this diagnosis should always be ruled out. The rupture of a parathyroid adenoma is a rare, but possibly life-threatening event due to airways compression and hemodynamic instability. Testing for hypercalcemia and hyperparathyroidism is mandatory to obtain a correct diagnosis.
Yeh MW, Ituarte PH, Zhou HC, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab 2013;98:1122-9.
DOI: https://doi.org/10.1210/jc.2012-4022
Adami S, Marcocci C, Gatti D. Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 2002;17:N18–N23.
Christensson T, Hellström K, Wengle B, et al. Prevalence of hypercalcaemia in a health screening in Stockholm. Acta Med Scand 1976;200:131–7.
DOI: https://doi.org/10.1111/j.0954-6820.1976.tb08208.x
Wermers RA, Khosla S, Atkinson EJ, et al. The rise and fall of primary hyperparathyroidism: a population-based study in Rochester, Minnesota, 1965–1992. Ann Intern Med 1997;126:433–40.
DOI: https://doi.org/10.7326/0003-4819-126-6-199703150-00003
Yu N, Donnan PT, Murphy MJ, Leese GP. Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol 2009;71:485–93.
DOI: https://doi.org/10.1111/j.1365-2265.2008.03520.x
Kovacs KA, Gay JD. Remission of primary hyperparathyroidism due to spontaneous infarction of a parathyroid adenoma. Case report and review of the literature. Medicine 1998;77:398–402.
DOI: https://doi.org/10.1097/00005792-199811000-00005
Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin N Am 2000;38:1105–29.
Chaffanjon PCJ, Chavanis N, Chabre O, Brichon PY. Extracapsular Hematoma of the Parathyroid Glands. World J Surg 2003;27:14‐7.
DOI: https://doi.org/10.1007/s00268-002-6429-y
Yoshimura N, Mukaida H, Mimura T, et al. A case of an acute cervicomediastinal hematoma secondary to the spontaneous rupture of a parathyroid adenoma. Ann Thorac Cardiovasc Surg 2014;20:816‐20.
DOI: https://doi.org/10.5761/atcs.cr.12.02060
An L, Ji T, Li L. Diffuse hematoma caused by spontaneous rupture of a parathyroid adenoma: a case report. Braz J Otorhinolaryngol 2020;86:48-50.
DOI: https://doi.org/10.1016/j.bjorl.2017.06.006
Merante‐Boschin I, Fassan M, Pelizzo MR, et al. Neck emergency due to parathyroid adenoma bleeding: a case report. J Med Case Rep 2009;3:7404.
DOI: https://doi.org/10.1186/1752-1947-3-7404
Shinomiya H, Otsuki N, Takahara S‐I, et al. Parathyroid adenoma causing spontaneous cervical hematoma: two case reports. BMC Res Notes 2015;8:726.
DOI: https://doi.org/10.1186/s13104-015-1611-0
Rehman HU, Markovski M, Khalifa A. Spontaneous cervical hematoma associated with parathyroid adenoma. CMAJ 2010;182:E632.
DOI: https://doi.org/10.1503/cmaj.091167
Kihara M, Yokomise H, Yamauchi A, et al. Spontaneous rupture of a parathyroid adenoma presenting as a massive cervical hemorrhage: report of a case. Surg Today 2001;31:222‐4.
Hotes LS, Barzilay J, Cloud LP, Rolla AR. Spontaneous hematoma of a parathyroid adenoma. Am J Med Sci 1989;297:331–3.
DOI: https://doi.org/10.1097/00000441-198905000-00012
Hellier WP, McCombe A. Extracapsular haemorrhage from a parathyroid adenoma presenting as a massive cervical haematoma. J Laryngol Otol 1997;111:585–7.
DOI: https://doi.org/10.1017/S0022215100137995
Ku P, Scott P, Kew J, van Hasselt A. Spontaneous retropharyngeal haematoma in a parathyroid adenoma. Aust N Z J Surg 1998;68:619–21.
DOI: https://doi.org/10.1111/j.1445-2197.1998.tb02117.x
Kihara M, Yokomise H, Yamauchi A, et al. Spontaneous rupture of a parathyroid adenoma presenting as a massive cervical hemorrhage: report of a case. Surg Today 2001;31:222–4.
DOI: https://doi.org/10.1007/s005950170172
Jougon J, Zénnaro O. Acute cervico-mediastinal hematoma of parathyroid origin. Ann Chir 1994;48:867–9.
Kataoka K, Taguchi M, Takeshita A, et al. Recurrence of primary hyperparathyroidism following spontaneous remission with intracapsular hemorrhage of a parathyroid adenoma. J Bone Miner Metab 2008;26:295–7.
DOI: https://doi.org/10.1007/s00774-007-0816-2
Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin N Am 2000;38:1105–29.
DOI: https://doi.org/10.1016/S0033-8389(05)70224-4
Gritzmann N, Koischwitz D, Rettenbacher T. Sonography of the thyroid and parathyroid glands. Radiol Clin N Am 2000;38:1131–45.
DOI: https://doi.org/10.1016/S0033-8389(05)70225-6
How to Cite
Porta, L., Ghezzi, R., Cadonici , A. C., Dalino Ciaramella , P., Martes, C., Basile, A., & Bellone, A. (2021). An unusual case of neck hematoma and hypercalcemia. Emergency Care Journal, 17(3). https://doi.org/10.4081/ecj.2021.9548
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Gianfranco Cervellin, Ivan Comelli, Giuseppe Lippi, Denis Comelli, Gianni Rastelli, Paolo Ossola, Carlo Marchesi, The number of emergency department visits for psychiatric emergencies is strongly associated with mean temperature and humidity variations. Results of a nine year survey , Emergency Care Journal: Vol. 10 No. 1 (2014)
- R.A. Colombo, C. Fraticelli, Uneasy working and uncertainties facing: the power of intuition in emergency decision making. Neuro-psychobiological correlates , Emergency Care Journal: Vol. 8 No. 3 (2012)
- Antonio Agosti, Silvia Bricchi, Francesca Rovati, Mara Vancea Opris, Davide Giulio Ponzi, Francesco Mariani, Nicola Morelli, Andrea Magnacavallo, Andrea Vercelli, Erika Poggiali, A sabbath in the emergency room or a case of anticholinergic toxicity? , Emergency Care Journal: Vol. 18 No. 1 (2022)
- Manuel Monti, Alessio Monti, Francesco Borgognoni, Giovanni Maria Vincentelli, Federico Paoletti, Treatment with lipid therapy to resuscitate a patient suffering from toxicity due to local anesthetics , Emergency Care Journal: Vol. 10 No. 1 (2014)
- Kori Sauser, Lora Alkhawam, Linda Pierchala, Peter S. Pang, Lactate levels as a marker of tissue hypoperfusion in acute heart failure patients seen in the emergency department: a pilot study , Emergency Care Journal: Vol 12, No 1 (2016)
- Adrianna Long, Robert Cambridge, Melissa Rosa, Physician’s changes in management of return visits to the Emergency Department , Emergency Care Journal: Vol 12, No 1 (2016)
- Erika Poggiali, Davide Bastoni, Mariachiara Ferrari, Dario Moretto, Federico Buttafava, Pau Mateo Ramos, Valentina Burzio, Jolanda Petri, Andrea Magnacavallo, Andrea Vercelli, COVID-19 or not COVID-19, that is the question. The role of screening criteria and point-of-care lung ultrasound in the triage decision-making process in an Emergency Department during the phase 2 of the COVID-19 Italian epidemic , Emergency Care Journal: Vol. 17 No. 2 (2021)
- Daniel Poor, Mayra Ramirez, Terrance McGovern, Ninad Shroff, A rare cause of pneumoperitoneum , Emergency Care Journal: Vol. 13 No. 1 (2017)
- Nicola Parenti, Federica Agrusta, Antonio Luciani, Which clinical scoring system should we use for the evaluation of chest pain in the Emergency Department? A review , Emergency Care Journal: Vol. 12 No. 2 (2016)
- Gianmarco Secco, Giovanni Cappa, Bruno Barcella, Stefano Perlini, The role of emergency medicine residents during the global SARS-Cov-2 pandemic: The Pavia experience , Emergency Care Journal: Vol. 17 No. 1 (2021)
You may also start an advanced similarity search for this article.
