Inhabitual presentation of parathyroid adenoma

Amel Elkorbi; Nawres Bouaziz; Mahdi Ferjaoui; Rachida Bouatay; Naourez Kolsi; Harrathi Khaled; Jamel Koubaa

doi:10.1530/endoabs.99.EP725

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Endocrine Abstracts (2024) 99 EP725 | DOI: 10.1530/endoabs.99.EP725

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

Inhabitual presentation of parathyroid adenoma

Amel Elkorbi ¹ , Nawres Bouaziz ¹ , Mahdi Ferjaoui ¹ , Rachida Bouatay ¹ , Naourez Kolsi ¹ , Harrathi Khaled ¹ & Jamel Koubaa ¹

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¹مستشفى فطومة بورقيبة بالمنستير, Monastir, Tunisia

Introduction: Spontaneous extracapsular hemorrhage of a parathyroid adenoma causing cervico-mediastinal hematoma is a rare but life-threatening manifestation. Our objective is to present a rare case of cervico-thoracic hematoma secondary to a spontaneous rupture of a parathyroid adenoma and to specify its clinical, radiological, therapeutic and evolutionary features.

Case report: This is a 50-year-old woman with no significant pathological history who presented to the emergency department for cervico-thoracic ecchymotic lesions associated with upper dysphagia. History evoluted for five days. There was no context of trauma or anticoagulant treatment. The patient complained from generalized bone pain. Physical examination find no cervical mass. A cervico-thoracic scan was showed an extended retropharyngeal hematoma extended to the posterior mediastin associated with signs of compression. We noted also an inferior right retro-thyroid nodule. Parathormone levels was elevated PTH, malignant hypercalcemia and hypophosphoremia were also observed. The diagnosis of symptomatic primary hyperparathyroidism was concluded. Cervical ultrasound and MIBI scintigraphy confirmed the parathyroid nature of this nodule. A lower right parathyroidectomy was performed after correction of serum calcium. The evolution was marked by the normalization of the phosphocalcium balance and the absence of recurrence of the hematoma with a follow-up of one year.

Discussion/Conclusion: The parathyroid origin should be evoked in the presence of any spontaneous cervico-thoracic hematoma associated with compressive signs. The association, although rare, is still possible.

Disclosure of interest: none declared