Spontaneous rupture of the parathyroid adenoma with formation cervico-retrosternal cyst and massive hematoma: a case report

In this case report the authors inform about cervico-retrosternal cyst of the parathyroid gland, which develops as a result of spontaneous rupture of the adenoma and the formation of a hematoma with the development of neck compression syndrome. The patient was admitted to the clinic, a week after the onset of the disease, with complaints of dyspnea at rest, stridor breathing, weakness and mass formation of the right lateral region of the neck. There is no history of injuries, pathological fractures or invasive manipulations on the neck, indications of pathology of the thyroid or parathyroid glands. According to multispiral computed tomography, a volumetric fluid formation of the neck and upper mediastinum 63×57 mm in size with compression and narrowing of the trachea up to 5 mm was found. To clarify whether the formation belongs to the thyroid gland or the thyroid gland, a transcutaneous puncture was performed. The level of parathyroid hormone in the liquid is more than 2500 mg / ml, and in the blood — 304.9 pg / ml — parathyroid cyst. Using an increase in compression syndrome, removal of a cyst in a block with adenoma of the right lower parathyroid gland with achievement of remission of primary hyperparathyroidism. This clinical observation shows a rare course of parathyroid adenoma with rupture and hematoma formation, which led to the development of neck compression syndrome.