Abstract
IntroductionSudden swelling of the neck is an emergency situation that can be life-threatening for the patient. Therefore, an understanding of the possible underlying pathology is of great importance. Sudden massive swelling of the neck because of intralesional bleeding of a thyroid adenoma is seldom encountered but must be considered. Such massive swelling caused by spontaneous bleeding of a thyroid adenoma has not yet been described in the literature.Case presentationWe report the case of a 71-year-old Caucasian man with sudden massive neck swelling due to intralesional bleeding of a thyroid adenoma. We present his clinical history, physical examination results, computed tomography (CT) scans, and histological findings after surgery. He presented with sudden massive swelling of the left side of his neck after sneezing while working with his hands over his head. An ear, nose, and throat examination showed a painless swelling of the left side of his neck and a displacement of his larynx to the right. CT scans revealed a mass originating from the left lobe of his thyroid gland and the mass displaced his larynx and trachea. A surgical exploration showed a greatly enlarged left lobe of his thyroid gland. A histopathological examination showed a hemorrhagic infarction of a follicular thyroid adenoma.ConclusionsSudden intralesional bleeding of a thyroid adenoma is a rare condition but one that should be considered in cases of sudden and massive swelling of the neck.
Highlights
Sudden swelling of the neck is an emergency situation that can be life-threatening for the patient
Case presentation: We report the case of a 71-year-old Caucasian man with sudden massive neck swelling due to intralesional bleeding of a thyroid adenoma
We present his clinical history, physical examination results, computed tomography (CT) scans, and histological findings after surgery
Summary
Follicular adenomas, arising from the thyroid follicles, are the most common benign tumors of the thyroid gland. A clinical examination showed a painless mass in the left side of his neck but no signs of inflammation or ecchymosis. An ultrasound of his neck showed a heterogeneous, well-defined mass that was located medial to his sternocleidomastoid muscle and that displaced his carotid artery and jugular vein. Computed tomography (CT) scans of his neck (Figure 1, Figure 2 and 3) showed a large mass that measured approximately 6 × 7 × 12 cm and originated in the left lobe of his thyroid gland. The mass displaced his larynx and trachea to the right and extended from the subclavicular to the submandibular region. A histopathological examination revealed a follicular thyroid adenoma with a hemorrhagic infarction
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