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23.09.2021 | Original Article

Spontaneous extracapsular parathyroid adenoma hemorrhage: when surgery is required?

verfasst von: Marco Familiari, Davide Di Santo, Andrea Galli, Giulia Danè, Leone Giordano, Renata Mellone, Mario Bussi

Erschienen in: Endocrine | Ausgabe 2/2022

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Abstract

Purpose

Spontaneous bleeding is a rare but serious complication of parathyroid adenomas and few cases were reported in the literature. Clinical manifestations and treatment may vary but sometimes an immediate surgery is required. In other cases a conservative approach can be preferred based on clinical stability and patients’ conditions. The purpose of this work is to describe our case and to carry out a review of the current literature on this topic.

Methods

We reported a case of a parathyroid adenoma hemorrhage in an elderly patient describing its management. Moreover, a literature review of 57 cases was carried out, with the aim of collecting data about the most involved parathyroid gland and identifying the most correct management based on clinical manifestations and chosen treatments.

Results

The patients had an age between 29 and 81 years (mean 56.9 ± 16.4 years). Forty-four patients were females (77.2%), whereas 12 were males (21.8%). Based on clinical severity, age, comorbidities and calcemic status, three possible scenarios were identified, each with a recommended management.

Conclusions

In parathyroid adenoma hemorrhages a careful clinical assessment is crucial to identify emergency conditions requiring immediate intubation, tracheostomy or neck exploration. Elderlies and comorbid patients have a higher risk of perioperative complications and indication for surgery should be evaluated case by case: whenever feasible, a conservative approach should be preferred in these subjects, especially in those with a stable course and without hypercalcemia-related symptoms.

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Titel: Spontaneous extracapsular parathyroid adenoma hemorrhage: when surgery is required?
verfasst von: Marco Familiari
Davide Di Santo
Andrea Galli
Giulia Danè
Leone Giordano
Renata Mellone
Mario Bussi
Publikationsdatum: 23.09.2021
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 2/2022
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-021-02876-x

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Spontaneous extracapsular parathyroid adenoma hemorrhage: when surgery is required?

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