Parathyroid cysts: experience of a rare phenomenon at a single institution

Abstract

BackgroundParathyroid cysts are relatively uncommon lesions and are often misdiagnosed. We evaluate our experience in the diagnosis of and therapy to correct parathyroid cystic lesions.MethodsWe retrospectively reviewed a series of 32 patients with parathyroid cysts who were admitted to our department between July 2011 and November 2016. Clinical pathological features of the patients, including age, gender, location, size, ultrasonography, histopathology, surgery, and follow-up, were analyzed.ResultsThere were 22 female and 10 male participants with a median age of 46.7 years old (27–76 years old). Only two cysts were found in the superior mediastinum. The rest were located under the lower pole of the thyroid. All of the patients underwent ultrasonography scans and serum parathyroid hormone (PTH) assays. Three patients had elevated serum PTH levels, and they were further scanned with Tc99m sestamibi as functional cysts. In 29 cases of nonfunctional cysts, 3 cases were preoperatively diagnosed by cystic aspiration with PTH detection. The rest were diagnosed by postoperative immunopathology. All of the patients underwent cystectomy, and 24 patients also underwent thyroidectomy. There was a significant difference in cyst diameter size between the cystectomy alone and cystectomy with thyroidectomy groups (4.0 ± 2.0 vs 1.5 ± 1.0 cm; p < 0.05). No participant experienced recurrence during the median 36 months of follow-up.ConclusionsCystic lesions located under the lower pole of the thyroid gland should be considered to have originated at the parathyroid gland. Cystic aspiration with PTH detection or postoperative immunopathology can lead to a definitive diagnosis. Cystectomy is still a commonly used and effective treatment.

Parathyroid Cyst: A Case Report of an Uncommon Diagnosis of a Cervical Mass

“…The main indications for surgery reported in the literature are functioning PCs, uncertain diagnosis of PCs, the possibility of malignancy, symptomatic PCs, and recurrences. According to Xu et al, the optimal treatment for nonfunctional PCs with diameters greater than 2.5 cm is surgical resection [15]. In our case, the patient underwent cyst resection without any postoperative complications or recurrence during the follow-up.…”

Parathyroid cyst: A rare entity

“…Regarding their secreting character, PCs are subdivided into two main categories: functioning and nonfunctioning cysts. 1 , 2 Functioning cysts make up 10%–20% of PCs. 1 , 2 , 5 One case of functioning PC was noted in our study.…”

“…1 They are classified as functioning and nonfunctioning cysts. 1 , 2 PCs are mostly nonfunctioning ones with nonspecific physical and radiological features. 1 – 3 What characterizes PCs is the presence of parathyroid hormone (PTH) in the cystic fluid.…”

Non-functional parathyroid cyst masquerading as a thyroid cyst: Report of two cases and review of the literature

“…More commonly than not, they are found as solitary cysts located near the lower poles of the thyroid gland [2].…”

“…They are typically classified as functional or non-functional, depending on their association with hyperparathyroidism [2]. The majority of cases are non-functional [3].…”