Spontaneous neck hemorrhage secondary to parathyroid adenoma: description of a case and systematic review| ACTA Otorhinolaryngologica Italica

Abstract

Introduction: Parathyroid adenomas can rarely cause spontaneous hemorrhage, which can be life-threatening. Diagnosis is challenging. We present a case and systematic review to define a clearer pattern of symptoms, diagnosis, and treatment. Materials and Methods: We conducted a literature search of PubMed, Google Scholar, and Embase using PRISMA guidelines, identifying 38 relevant case reports on parathyroid adenomas from 1974 to 2021. Data included epidemiology, clinical features, and treatment. One patient treated at our clinic is described, with their informed consent. Results: Reviewing 38 articles, we found cervical hematomas in 45 patients, with 33 women and 12 men. Common symptoms were neck pain, dysphagia, and swelling. Surgery was the primary treatment, with 4.4% requiring tracheotomy. Average hospital stay was 12.5 days, mostly complication-free. Conclusion: Suspect parathyroid adenoma hemorrhage in middle-aged women with neck swelling, pain, and swallowing difficulty. Diagnosis involves blood tests and contrast CT. Treatment is adenoma removal, typically without major complications.