WITHDRAWN: Parathyroid adenoma complicated by giant cystic hematoma: A case report

Abstract

Parathyroid adenoma is a parathyroid tumor, which is relatively rare compared to other tumors. Some tumors degenerate and form cysts due to poor local blood supply. We report a rare case of a man with a pathologically confirmed cystic degeneration of parathyroid adenoma. The patient was a 60-year-old male who presented with a three-year complaint of being aware of a progressively enlarging right neck mass. Initially, he had experienced no special clinical symptoms, but with the exception of sudden breathing difficulty during hospitalization, the primary disease could not be confirmed clinically. There had also been no typical uptake on parathyroid imaging. However, laboratory tests revealed hyperparathyroidism. After an emergency neck exploration, a second “right thyroid and cystic tumor resection” was performed. The postoperative pathological report indicated a parathyroid adenoma with cystic degeneration. The patient recovered well after the operation and was discharged. Parathyroid adenoma complicated by giant cystic hematoma comprises a unique surgical entity with diagnostic and management difficulties. It is extremely rare for this patient to have progressive neck enlargement without obvious symptoms. We perfected the needle biopsy for a definite diagnosis, but the next day there was a sharp swelling of the neck with dyspnea, which was considered as the possibility of acute hemorrhage of cystic parathyroid adenoma. Therefore, we suggest that for such patients, operations such as puncture should be avoided. In cystic parathyroid adenoma, the occurrence of acute dyspnea after stimulus manipulation warrants the need for early diagnosis and timely surgery to avoid risks. • A progressively enlarging neck mass may also be a cystic parathyroid adenoma with hemorrhage. • Puncture can cause acute parathyroid adenoma intracapsular hemorrhage • The 99mTc-MIBI parathyroid imaging in parathyroid adenoma without radioactive uptake, but laboratory tests showed hyperparathyroidism.