Spontaneous cervical haematomas are rare occurrences for which a wide variety of aetiologies have been reported. Although the pathogenesis of this condition can be quite diverse, all known cases have emanated from a cervical source. The authors report the first case of a spontaneous cervical haematoma arising from an intrathoracic source. A case review and Medline search from 1962–2003 was carried out.

No prior experience with intrathoracic sources for cervical haematomas has previously been reported. Transcervical haematoma evacuation confirmed the intrathoracic origin and a median sternotomy was required to gain control of this haemorrhage.

Thoracic sources should be considered in the differential diagnosis of a spontaneous cervical haematoma. Preparations for a combined procedure with a thoracic surgeon can be predicted pre-operatively based on imaging studies.