Hemorrhage into thyroid adenomas is relatively common but usually does not attain clinical significance. Small hemorrhages and the secondary results of hemorrhages, such as necrosis or cystic degeneration in thyroid nodules, are frequently seen by pathologists on gross or microscopic examination. A massive hemorrhage into a thyroid adenoma of sufficient magnitude to produce respiratory obstruction necessitating emergency surgical treatment is indeed rare. Wendel1 reports the case of a patient 55 years old with sudden asphyxia and choking, unconsciousness, and a tumor in the neck. Emergency treatment consisted of opening the tumor mass, followed by marked improvement, and later taking the patient to a hospital, still unconscious, with surgical removal of the remaining abnormal tissue. The patient, however, failed to gain consciousness and died. Hertzler2 states: "Hemorrhage into a substernal goiter may suddenly increase the volume of the tumor. One of my patients, known to have a substernal goiter,
BERENS JJ, EASELEY RF. Massive Thyroid Hemorrhage Producing Acute Respiratory Obstruction. AMA Arch Surg. 1958;77(2):165–167. doi:10.1001/archsurg.1958.01290020015003
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