Abstract
Rationale:Spontaneous anterior cervical or mediastinal hemorrhage is a rare presentation of parathyroid adenoma.Patient concerns:A 69-year-old woman presented with neck hematoma and dysphagia and was found to have a soft tissue mass adjacent to her thyroid gland as seen on MRI and neck ultrasound.Diagnosis:Laboratory testing demonstrated elevated calcium and parathyroid hormone supporting diagnosis of parathyroid adenoma.Interventions:She underwent right inferior parathyroidectomy and en bloc right hemithyroidectomy due to significant fibrosis.Outcomes:Pathology confirmed hypercellular parathyroid and normal thyroid tissue. Postoperatively, patient's calcium and parathyroid hormone levels had normalized.Lessons:In conclusion, imaging may not always be specific in identifying the source of neck hematoma and so laboratory studies should be done to rule out parathyroid adenoma as the underlying etiology.
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