Table 1 Classification of parathyroid apoplexy proposed by Nylen et al [9]

I

Adenoma with necrosis without hemorrhage

Asymptomatic, GI discomfort/pain, joint pain, cervical pain

Initial hypercalcemia- hypocalcemia

Adenoma with intracapsular hemorrhage and necrosis

Asymptomatic, GI discomfort, cervical pain, tetany, convulsions

Initial hyper- or hypocalcemia

Adenoma with extracapsular hemorrhage

Acute pain (neck to substernal), dysphagia, dysphonia, hoarseness, stridor, hypercalcemic crisis, widened mediastinum, visible hematoma or ecchymoses

Stable postoperative course, normocalcemia