Abstract
A healthy 34-year-old woman presented with an acute, painful swelling and bluish discoloration of the anterior neck with no associated trauma. She reported having fatigue, anorexia, and depression during the past few weeks. On examination, she had extensive ecchymosis of the anterior neck and chest (Panel A). Laryngoscopy showed a hematoma at the level of the arytenoid and epiglottis. Laboratory tests revealed a serum calcium level of 5.8 mmol per liter (23.1 mg per deciliter) (normal range, 2.2 to 2.6 mmol per liter [8.8 to 10.6 mg per deciliter]), a serum phosphate level of 0.7 mmol per liter (2.2 mg . . .
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