Parathyroid Cysts: A Case Report and Review of the Literature

Abstract

Parathyroid cysts are rare clinical entities. They frequently present as a clinical diagnostic problem. They may mimic solitary thyroid nodules. The purpose of the study was to review the literature and present a case of a 22-year-old euthyroid woman presenting with recurrent swelling in the neck. Her complaints included choking and dysphagia. Fine-needle aspiration of the mass revealed clear, watery fluid with an extremely high level of calcium and c-terminal midmolecule parathyroid hormone assay in excess of 8000 pg/mL. Treatment consisted of neck exploration and removal of a 6 x 5-cm cystic encapsulated mass. Pathological diagnosis revealed a benign parathyroid cyst. The role of needle aspiration in diagnosing thyroid masses and the importance of parathyroid hormone assay in diagnosing parathyroid cyst are emphasized.

Cisto de paratireóide: aspectos diagnósticos e tratamento

“…In a study with thyroid and parathyroid specimens examined within a period of 15 years, parathyroid cysts were found in 0.6% 3 . Analyses in autopsies revealed 40 to 50% of parathyroid glands that contained asymptomatic microcysts 5 , given that in only 1 to 3% they presented as a neck mass 6 . Parathyroid cysts occur in both genders, with the proportion of 2.5:1 women to men, normally at the 4th and 5th decades of life 7 .…”

“…Parathyroid cysts occur in both genders, with the proportion of 2.5:1 women to men, normally at the 4th and 5th decades of life 7 . The vast majority is located in lower parathyroid glands, described from the mandible angle to the mediastinum, with slight predominance on the left 5 .…”

“…Most parathyroid cysts are asymptomatic. The main symptoms caused by the local compressive effect of the lesion when it becomes larger include dysphagia, hoarseness, pain, neck mass or dyspnea by tracheal deviation 5 . Hoarseness is caused by vocal fold paresis, which can be explained by edema and fibrosis of recurrent laryngeal nerve combined with pressure or traction of the cyst wall 10 .…”

A rare case of a parathyroid adenoma inside a parathyroid cyst

“…This is a case of parathyroid adenoma within a 4 cm PC. Functional PCs represent 20% of cases, manifest PTH hypersecretion, are revealed in 0.3-3% of the parathyroid glands removed due to primary hyperparathyroidism (3), have no typical location and are found predominantly in men (3,4).…”

“…P arathyroid cysts (PCs) were first described in 1880 and they comprise rare lesions of the neck or mediastinum, with more than eight five percent of them located in the neck, usually involving the lower parathyroid glands, and the rest of them located between the mandible and mediastinum (1)(2)(3)(4). PCs are subdivided into functioning and nonfunctioning depending on their ability to secrete PTH or not.…”