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Clinical Note |

Sudden Dysphonia Due to Spontaneous Bleeding in Secondary Parathyroid Hyperplasia

Tetsuya Terada, PhD; Ryo Kawata, PhD; Masaaki Higashino, MD; Motomu Tuji, PhD; Hiroshi Takenaka, PhD
Arch Otolaryngol Head Neck Surg. 2007;133(6):608-609. doi:10.1001/archotol.133.6.608.
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A 51-year-old woman presented with sudden-onset dysphonia that was caused by acute vocal cord paralysis as a result of bleeding within a hyperplastic upper right parathyroid gland. She was referred to our hospital for the treatment of secondary hyperparathyroidism due to chronic renal failure. She had been receiving hemodialysis for 7 years and had developed parathyroid hyperplasia associated with severe hypercalcemia and hyperphosphatemia. An acute onset of vocal cord paralysis is rarely associated with benign processes, and, to our knowledge, the case reported herein is the first one that has been associated with secondary parathyroid hyperplasia.

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Figure 1.

Computed tomographic image of the neck at the level of the lower pole of the thyroid gland. Arrow indicates the enlarged parathyroid gland on the right side.

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Figure 2.

Intraoperative view of the recurrent laryngeal nerve on the parathyroid gland (arrows).

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Figure 3.

Histologic appearance of the hyperplastic parathyroid gland showing hemosiderin deposition.

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