[Parathyroid adenoma disclosed by a massive subcapsular hemorrhage]

Area of Science:

• Endocrinology
• Surgical Pathology
• Diagnostic Imaging

Background:

• Parathyroid gland adenomas are typically slow-growing tumors.
• Subcapsular hematomas are rare complications of parathyroid adenomas.
• Silent adenomas present without overt hormonal symptoms until a complication arises.

Observation:

• A large subcapsular hematoma developed spontaneously, compressing cervical structures.
• Recurrent laryngeal nerve paralysis was a presenting symptom.
• Transient, spontaneously regressive hypercalcemia was noted.

Findings:

• The hematoma revealed a previously undiagnosed parathyroid adenoma.
• Thyroid scintigraphy and cervical ultrasonography aided in diagnosis.
• The combination of hematoma, nerve paralysis, and hypercalcemia points to parathyroid origin.

Implications:

• This case highlights a rare but serious presentation of parathyroid adenoma.
• Prompt surgical intervention is essential for managing compressive hematomas and associated complications.
• Diagnostic imaging plays a vital role in identifying the source of cervical masses and endocrine emergencies.