Bilateral thyroid hematomas after fine-needle aspiration causing acute airway obstruction

Fine-needle aspiration of the thyroid gland is a common procedure that is increasingly being used to evaluate thyroid nodules incidentally found by other imaging means such as computed tomography scans. Rare complications include hematoma, transient vocal cord paralysis, seeding of carcinoma cells, and infection. Of these, hematoma is the most common and is usually small and adequately treated with compression of the site. Only two cases have been previously reported describing large thyroid hematoma after fine-needle aspiration resulting in acute airway compromise and requiring surgical decompression.

We report an interesting case of large bilateral thyroid hematomas after routine fine-needle aspiration causing acute airway obstruction in a patient with hypertension and end stage renal disease taking aspirin.