Spontaneous retropharyngeal hematoma of a parathyroid cyst: report of a case

Surg Today. 2003;33(5):354-7. doi: 10.1007/s005950300080.

Abstract

A 41-year-old woman presented with severe and sudden anterior neck swelling, pain, and dysphagia. Computed tomography (CT) scan and ultrasound of the neck showed a giant mass in the retropharyngeal space, displacing the trachea and esophagus anteriorly. Aspiration cytology was done, following which extensive cervical and chest ecchymosis occurred and her symptoms immediately improved. A repeat CT scan demonstrated that the cervical giant mass had vanished, but there was a residual mass in the left paratracheal space. Exploratory surgery of the neck revealed a parathyroid cyst with severe adhesion to the surrounding tissues. We considered that a ruptured parathyroid cyst had induced massive hemorrhage into the cervical tissues and mediastinum, but that the hemorrhage had been absorbed. Extracapsular hemorrhage from a parathyroid adenoma or cyst is rare, especially from a parathyroid cyst. In fact, to our knowledge, this represents only the third case of symptomatic spontaneous bleeding of a parathyroid cyst. Nevertheless, this entity should still be considered in the differential diagnosis of all rapidly progressing retropharyngeal masses.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / complications*
  • Adenoma / diagnostic imaging
  • Adult
  • Cysts / complications*
  • Cysts / diagnostic imaging
  • Diagnosis, Differential
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / etiology*
  • Humans
  • Neck
  • Parathyroid Neoplasms / complications*
  • Parathyroid Neoplasms / diagnostic imaging
  • Radiography
  • Rupture, Spontaneous