Background. Spontaneous rupture of a hyperplastic parathyroid gland or
adenoma resulting in extracapsular hemorrhage is extremely rare. Meth
ods. We report a case of traumatic rupture of a cervical parathyroid g
land adenoma. Results. The patient had progressive stridor, neck swell
ing, and chest and back pain with evidence of ongoing blood loss resul
ting in airway compromise. Exploration of the neck and superior medias
tinum revealed hypercellular parathyroid tissue consistent with adenom
a or hyperplasia. Conclusions. Traumatic rupture of an enlarged parath
yroid gland is a distinct and potentially lethal cause of unexplained
cervical or mediastinal hemorrhage after blunt neck trauma. Failure to
consider the diagnosis may result in delayed operative intervention w
ith persistent hemorrhage resulting in airway compromise.