Spontaneous Hematoma of a Parathyroid Adenoma
作者:
LAWRENCE HOTES,
JOSHAU BARZILAY,
LAWRENCE CLOUD,
ARTURO ROLLA,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 1989)
卷期:
Volume 297,
issue 5
页码: 331-333
ISSN:0002-9629
年代: 1989
出版商: OVID
关键词: Hypercalcemia;Hyperparathyroidism;Mediastinal Enlargement;Parathyroid Adenoma;Parathyroid Hematoma;Respiratory Insufficiency
数据来源: OVID
摘要:
A patient with long-standing asymptomatic, primary hyperparathyroidsim developed pain in the anterior neck area, with cough, dysphagia and increasing shortness of breath. This led to respiratory insufficiency, which required endotracheal intubation and respirator assistance, During the ensuring hours the patient developed an area of ecchymosis on the anterior chest. Chest x-ray showed widening of the superior mediastinum, and CT scan showed a large mass with a fluid level. Surgery revealed a large hematoma originating form a mediastinal parathyroid adenoma with a hemorrhagic infarct. Serum calcium, previously elevated, decreased to normal with the onset of neck pain, and the patient remains normocalcemic. Previous reported cases of this rare complication of parathyroid adenomas are reviewed. Hemorrhagic infarct of a parathyroid adenoma may present with a rapidly enlarging mediastinal mass, and/or hypercalcemic crisis. Surgical removal of the infarcted adenoma can return the serum calcium to normal.
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