RESUMEN
Intrathyroidal parathyroid adenoma is an infrequent lesion which can be explained by abnormalities during embryonic migration of the parathyroid glands. Extracapsular hemorrhage from a intrathyroidal parathyroid adenoma is extremely rare, however, due to its location near upper airway, it might cause a life-threatening situation. Therefore, if patients presented with anterior neck painful swelling, skin ecchymosis associated with dysphagia and/or hoarseness, extracapsular hemorrhage from parathyroid adenoma should be considered as a possible diagnosis. Estimation of serum calcium level is essential as the presence of hypercalcemia can help to make the diagnosis pre-operatively. As rupture of a parathyroid adenoma and cyst may lead to local dissemination of tumor cells and an increased risk of recurrent hyperparathyroidism, careful longterm follow-up is required. We report an unusual case of spontaneous rupture of intrathyroidal parathyroid adenoma with a review of literature.