Endocrine Abstracts

Introduction: Spontaneous cervical haematomas represent a rare condition. Few case reports have been published concerning spontaneous haematomas visible on the anterior side of a neck. These were caused by rupture of the superior thyroid artery, rupture of a thyroid nodule or the thyroid. A case of sternocleidomastoid haematoma due to haemorrhage into a nodal deposit of non-Hodgkin’s lymphoma has also been described.

Case report: A 39-year-old woman previously cured of mild thyroid autoimmune hypothyroidism noticed an enlargement and pain in the thyroid area after a probable viral infection with symptoms of increased body temperature. At the same time she developed a small lump on the superior edge of her thyroid cartilage. A few days later she noted a haematoma on her anterior neck and also noticed that the lump had disappeared.

Sonographical examination confirmed thyroid enlargement with a nonspecific structural pattern and a 0.3 ml hypoechogenic spherical formation in place of the previously described lump. The haematoma was caudal from the formation. No biopsy of the formation was performed due to itś size and superficial placement of the formation.

Conclusion: The source of bleeding was not detected with certainty. We hypothesized that a rupture of a previously asymptomatic thyroglossal cyst occurred during subacute (de Quervainś) thyroiditis because of the sudden enlargement of both the thyroid and the cyst. Less probable is enlargement of the thyroid due to activation of pre-existing autoimmune thyroiditis.