Spontaneous neck haematoma

A 66-year-old Caucasian woman presented with right-sided neck swelling and worsening pain for 5 days. There was no history of trauma, cough or excessive muscular strain. She was not on any anticoagulants or antiplatelet drugs. On initial examination, a 5×4 cm swelling was seen on the trapezius in the posterior triangle of the right side of the neck. The swelling was tender, firm and not mobile on palpation. A CT scan of the neck showed resolving haematoma 3 cm deep to the right trapezius muscle at the level of the hyoid bone. She was treated as an outpatient with analgesics. A repeat CT scan after 4 weeks showed complete resolution of the haematoma. A Medline literature search did not reveal any reported cases of spontaneous haematoma in the posterior triangle of the neck without any precipitating factor.