Uncommon presentations of parathyroid adenoma.

Abstract

Patients with parathyroid adenomas (PAs) are commonly encountered in otolaryngology and may present with asymptomatic hypercalcemia. Retropharyngeal hematoma and recurrent laryngeal nerve (RLN) paralysis are less commonly encountered presentations and may be harbingers of a malignant process. We present 2 patients with rare presentations of parathyroid adenoma. The first is a 57-year-old man with retropharyngeal hemorrhage and progressive airway compromise. The second is a 51-year-old woman presenting with dysphonia who was found to have RLN paralysis. Both of these patients were found to have benign disease. Although most patients with PA present with asymptomatic hypercalcemia, this disease entity must be considered in patients with other unusual presentations including hemorrhagic neck masses and dysphonia. The importance of a broad differential diagnosis and thorough workup is emphasized.