Giotakis Evangelos I, Hildenbrand Tanja, Dodenhöft Joachim
ENT Department, Städtisches Klinikum Karlsruhe, Moltkestrasse 90, 76133, Karlsruhe, Germany.
J Med Case Rep. 2011 Aug 18;5:391. doi: 10.1186/1752-1947-5-391.
Sudden swelling of the neck is an emergency situation that can be life-threatening for the patient. Therefore, an understanding of the possible underlying pathology is of great importance. Sudden massive swelling of the neck because of intralesional bleeding of a thyroid adenoma is seldom encountered but must be considered. Such massive swelling caused by spontaneous bleeding of a thyroid adenoma has not yet been described in the literature.
We report the case of a 71-year-old Caucasian man with sudden massive neck swelling due to intralesional bleeding of a thyroid adenoma. We present his clinical history, physical examination results, computed tomography (CT) scans, and histological findings after surgery. He presented with sudden massive swelling of the left side of his neck after sneezing while working with his hands over his head. An ear, nose, and throat examination showed a painless swelling of the left side of his neck and a displacement of his larynx to the right. CT scans revealed a mass originating from the left lobe of his thyroid gland and the mass displaced his larynx and trachea. A surgical exploration showed a greatly enlarged left lobe of his thyroid gland. A histopathological examination showed a hemorrhagic infarction of a follicular thyroid adenoma.
Sudden intralesional bleeding of a thyroid adenoma is a rare condition but one that should be considered in cases of sudden and massive swelling of the neck.
颈部突然肿胀是一种紧急情况，可能会危及患者生命。因此，了解可能的潜在病理情况非常重要。甲状腺腺瘤内出血导致颈部突然大量肿胀很少见，但必须予以考虑。文献中尚未描述过由甲状腺腺瘤自发性出血引起的这种大量肿胀情况。
我们报告一例71岁的白种男性患者，因甲状腺腺瘤内出血导致颈部突然大量肿胀。我们呈现了他的临床病史、体格检查结果、计算机断层扫描（CT）图像以及术后的组织学检查结果。他在双手举过头顶工作时打喷嚏后，左侧颈部突然出现大量肿胀。耳鼻喉检查显示左侧颈部无痛性肿胀，喉部向右移位。CT扫描显示一个起源于甲状腺左叶的肿块，该肿块使喉部和气管移位。手术探查显示甲状腺左叶明显肿大。组织病理学检查显示滤泡性甲状腺腺瘤出血性梗死。
甲状腺腺瘤内突然出血是一种罕见情况，但在颈部突然大量肿胀的病例中应予以考虑。
