Management of airway compromise following thyroid cyst hemorrhage after thrombolytic therapy

A case of spontaneous haemorrhage into the retropharyngeal and parapharyngeal space secondary to bleeding from a thyroid cyst is described. While many conditions are known to cause this entity, no previous papers have reported a thyroid cyst to cause such extensive haemorrhage. Haemorrhage in these spaces is of particular importance as it causes rapid airway compromise and can be life-threatening. Forty cases of non-traumatic retropharyngeal and parapharyngeal haematomas have been reported in the literature to date. Although the diagnosis can be easily established in most patients, no published review of this condition exists. This paper reviews all reports of non-traumatic retropharyngeal and parapharyngeal haematoma published in the literature to date and discusses management guidelines. We also present here for the first time the demographics and treatment results of this rare entity.

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A rare case of spontaneous thyroid cyst haemorrhage

The Journal of Laryngology & Otology ◽

10.1017/s0022215112001430 ◽

2012 ◽

Vol 126 (9) ◽

pp. 960-962 ◽

Cited By ~ 2

Author(s):

C C Chan ◽

A Awobem ◽

C Binns ◽

P Jassar

Keyword(s):

Computed Tomography ◽

Case Report ◽

Rare Case ◽

Needle Aspiration ◽

Airway Compromise ◽

Computed Tomography Scan ◽

Steroid Injections ◽

Intravenous Steroid ◽

Thyroid Cyst ◽

Tomography Scan

AbstractBackground:We report a case of hypopharyngeal swelling secondary to a spontaneous thyroid cyst haemorrhage. Haemorrhage is a known complication of thyroid cysts, and usually presents as external swelling and localised pain.Case report:A 93-year-old woman developed hypopharyngeal swelling, dysphagia and odynophagia. A computed tomography scan was consistent with thyroid cyst haemorrhage. The patient was treated with needle aspiration and intravenous steroid injections, with full recovery at thyroid clinic review.Conclusion:To our best knowledge, there has been no previous report of a hypopharyngeal swelling occurring secondary to spontaneous thyroid cyst haemorrhage. Our case is unusual because of the risk of airway compromise at the level of the hypopharynx, secondary to thyroid cyst haemorrhage.

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711 Atypical Presentation of a Ruptured Thyroid Cyst

British Journal of Surgery ◽

10.1093/bjs/znab134.022 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

Y Sahib ◽

M Aziz ◽

M Benamer

Keyword(s):

Chest Wall ◽

Early Recognition ◽

Thyroid Tissue ◽

Common Finding ◽

Airway Compromise ◽

Fine Needle Aspirate ◽

Anterior Neck ◽

Fine Needle ◽

Thyroid Cyst ◽

Life Threatening

Abstract Introduction Thyroid cysts are a common finding with the bulk of cases being benign and approximately only 5% being malignant. The majority of these cysts are managed conservatively in the absence of malignancy or compressive symptoms. Case presentation A middle-aged female patient presented with sudden onset anterior neck bruising but minimal specific symptomatology. On examination, the patient had bruising around the anterior neck and chest wall. CT and MRI scanning of the neck revealed the bruising was attributed to a ruptured thyroid cyst. On follow up, an ultrasound guided fine-needle aspirate revealed the histology to be inflammatory follicular thyroid tissue. D iscussion The case demonstrated a rare presentation, given the lack of trauma in her history nor the presence of more sinister conditions as demonstrated by the fine-needle aspirate. Normally hemorrhage of thyroid cysts are due to trauma or abnormal thyroid vasculature. There are a few previous case reports of similar presentations where ruptured thyroid cysts led to life-threatening airway compromise requiring intubation. Early recognition of these thyroid cyst complications is crucial. Conclusion Neck and anterior chest wall hematoma can be a sign of thyroid cyst rupture/hemorrhage. It is important to recognize this sign to prevent life-threatening airway compromise.

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