Diagnosis and Therapeutic Management of Parathyroid Cysts

Abstract

Objectives: The parathyroid cysts (PCs) are rare and their diagnosis and therapeutic management are not clearly established. The aim of the study was to evaluate the characteristics of parathyroid cysts. Methods and Materials: Twenty-five patients with PC were included in this retrospective study. The PCs were discovered as follows: cervical mass (n = 18), screening for other pathologies (n = 7). Intracystic parathyroid hormone determination was performed in 6 cases. Results: Eight patients presented an hyperparathyroidism. Mean cyst size was 21.1 mm (ext 4 - 70 mm) by 19.8mm (5 - 45 mm). Twenty four cysts were cervical (resection by cervicotomy), and one was mediastinal (resection by sternotomy). In addition to the resection of the PC, 3 adenomas, 1 hyperplasia of the parathyroid glands, 14 benign thyroid diseases and 4 papillary carcinomas were recognized and treated during the cervicotomies. Conclusion: The diagnosis of PC is uncommon and must be based primarily on the study of the cyst liquid obtained by percutaneous puncture (intracystic parathyroid hormone measurement). True PCs are non functional.

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J. Finel, S. Mucci, F. Branger, A. Venara, L. Blanchard and A. Hamy, "Diagnosis and Therapeutic Management of Parathyroid Cysts," Surgical Science, Vol. 3 No. 10, 2012, pp. 479-483. doi: 10.4236/ss.2012.310095.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] T. Delaunay, C. Peillon and J. L. Manouvrier, “Parathyroid Cyst. A Report of Six Cases,” Annales de Chirurgie, Vol. 44, No. 3, 1990, pp. 231-235.
[2] S. Nozeran, M. Duquenne, S. Guyetant, P. Rodien, V. Rohmer and J. Ronceray, “Diagnosis of Parathyroid Cyst: Importance of Dosage of Parathyroid Hormone in the Aspirated Fluid,” Presse Medicale, Vol. 29, No. 17, 2000, pp. 939-941.
[3] M. Akel, I. Salti and S. T. Azar, “Successful Treatment of Parathyroid Cyst Using Ethanol Sclerotherapy,” American Journal of the Medical Sciences, Vol. 317, No. 1, 1999, pp. 50-52. doi:10.1097/00000441-199901000-00007
[4] M. Zingrillo, M. R. Ghiggi and A. Liuzzi, “A Large Functioning Parathyroid Cyst Recurring after Aspiration and Subsequently Cured by Percutaneous Ethanol Injection,” Journal of Clinical Ultrasound, Vol. 24, No. 7, 1996, pp. 378-382. doi:10.1002/(SICI)1097-0096(199609)24:7<378::AID-JCU10>3.0.CO;2-D
[5] D. D. Lydiatt, R. M. Byers, K. G. Khouri, P. W. Whitworth and R. V. Sellin, “Functional Parathyroid Cyst and Hypocalciuric Hypercalcemia,” Ear, Nose, & Throat Journal, Vol. 72, No. 2, 1993, pp. 713-716.
[6] A. J. De Raimo, R. A. Kane, J. F. Katz and A. P. Rolla, “Parathyroid Cyst: Diagnosis by Sonography and Needle Aspiration,” American Journal of Radiology, Vol. 142, No. 6, 1984, pp. 1227-1228.
[7] D. Safran, “Functioning Parathyroid Cyst,” South Medical Journal, Vol. 91, No. 10, 1998, pp. 978-980. doi:10.1097/00007611-199810000-00018
[8] E. Garin, F. Le Gall, H. Sevestre and G. Leclech, “Latent Forms of Parathyroid Cysts. Report of Two Cases,” Annals de Pathologie, Vol. 14, No. 6, 1998, pp. 415-418.
[9] M. B. Ujiki, R. Nayar, C. Sturgeon and P. Angelos, “Parathyroid Cysts: Often Mistaken for a Thyroid Cyst,” World Journal of Surgery, Vol. 31, No. 1, 2007, pp. 60-64. doi:10.1007/s00268-005-0748-8
[10] W. R. Jarnagin and O. H. Clark, “Mediastinal Parathyroid Cyst Causing Persistent Hyperparathyroidism: Case Report and Review of the Literature,” Surgery, Vol. 123, No. 6, 1998, pp. 709-711. doi:10.1016/S0039-6060(98)70213-2
[11] T. W. Shields and S. C. Immerman, “Mediastinal Parathyroid Cysts Revisited,” The Annals of Thoracic Surgery, Vol. 67, No. 2, 1999, pp. 581-590. doi:10.1016/S0003-4975(99)00018-1
[12] A. F. Spitz, “Management of a Functioning Mediastinal Parathyroid Cyst,” Journal of Clinical Endocrinology and Metabolism, Vol. 80, No. 10, 1995, pp. 2866-2888. doi:10.1210/jc.80.10.2866
[13] V. L. Van Fossen and A. J. Edis, “Clear Parathyroid Cysts and Hyperparathyroidism,” The American Surgeon, Vol. 64, No. 12, 1998, pp. 1226-1228.
[14] D. B. Calandra, K. H. Shah, R. A. Prinz, H. Sullivan, C. Hofmann, R. Oslapas, K. Ernst, A. M. Lawrence and E. Paloyan, “Parathyroid Cyst: A Report of Eleven Cases Including Two Associated with Hyperparathyroid Crisis,” Surgery, Vol. 94, No. 6, 1983, pp. 887-892.
[15] A. T. Gurbuz and M. E. Peetz, “Giant Mediastinal Parathyroid Cyst: An Unusual Cause of Hypercalcemic Crisis-Case Report and Review of the Literature,” Surgery, Vol. 120, No. 5, 1996, pp. 795-800. doi:10.1016/S0039-6060(96)80086-9
[16] C. R. Hughes, B. Kanmaz, A. T. Isitman, G. Akansel, T. Lawson and B. D. Collier. “Misleading Imaging Results in the Diagnosis of Parathyroid Cysts,” Clinical Nuclear Medicine, Vol. 19, No. 5, 1994, pp. 422-425. doi:10.1097/00003072-199405000-00010
[17] B. Petitjean, “A Cervical Cyst,” Annales de Pathologie, Vol. 20, No. 3, 2000, pp. 273-274.
[18] K. J. Simic, M. T. Mc Dermott, G. J. Crawford, W. H. Marx, J. L. Ownbey and G. S. Kidd. “Massive Extracapsular Heamorrhage from a Parathyroid Cyst,” Archives of Surgery, Vol. 124, No. 11, 1989, pp. 1347-1350. doi:10.1001/archsurg.1989.01410110109023
[19] W. M. Lydiatt, A. R. Shaha, I. Munshi and R. Robbins. “Giant Mediastinal Cyst Masquerading as a Substernal Goiter,” Otolaryngology—Head and Neck Surgery, Vol. 116, No. 3, 1997, pp. 411-413. doi:10.1016/S0194-5998(97)70285-7
[20] A. Alvi, D. Myssiorek and P. Wasserman. “Parathyroid Cyst: Current Diagnostic and Management Principles,” Head and Neck, Vol. 18, No. 4, 1996, pp. 370-373. doi:10.1002/(SICI)1097-0347(199607/08)18:4<370::AID-HED8>3.0.CO;2-V
[21] O. Landau, D. W. Chamberlain, R. S. Kennedy, F. G. Pear- son and S. Keshavjee, “Mediastinal Parathyroid Cysts,” The Annals of Thoracic Surgery, Vol. 63, No. 4, 1997, pp. 951-953. doi:10.1016/S0003-4975(96)01392-6
[22] V. T. de Montpreville, “Mediastinal Parathyroid Cysts,” The Annals of Thoracic Surgery, Vol. 63, No. 4, 1997, pp. 951-953.
[23] B. Mitmaker, S. Lerman, E. Lamoureux and L. Begin, “Parathyroid Cyst: Diagnosis and Treatment of an Unusual Surgical Problem,” Canadian Journal of Surgery, Vol. 34, No. 1, 1991, pp. 59-61.
[24] E. G. Lever, S. Refetoff, F. H. Straus 2nd, M. Nguyen and E. L. Kaplan, “Coexisting Thyroid and Parathyroid Disease—Are They Related?” Surgery, Vol. 94, No. 6, 1983, pp. 893-900.
[25] G. Ippolito, F. Fausto Palazzo, F. Sebag, M. Sierra, C. De Micco and J. F. Henry, “A Single Institution 25-Year Review of True Parathyroid Cysts,” Langenbeck’s Archives of Surgery, Vol. 391, No. 1, 2006, pp. 13-18. doi:10.1007/s00423-005-0579-y
[26] B. C. Jha, N. M. Nagarkar, S. Kochhar, H. Mohan and A. Dass, “Parathyroid Cyst: A Rare Cause of Anterior Neck Mass,” The Journal of Laryngology and Otology, Vol. 113, No. 1, 1999, pp. 73-75. doi:10.1017/S0022215100143208
[27] A. Sanchez and H. Carretto, “Treatment of Non-Functioning Parathyroid Cyst with Tetracycline Injection,” Head & Neck, Vol. 15, No. 3, 1993, pp. 263-265. doi:10.1002/hed.2880150317
[28] B. Shi, H. Guo and N. Tang, “Treatment of Parathyroid Cysts with Fine Needle Aspiration,” Annals of Internal Medicine, Vol. 131, No. 10, 1999, pp. 797-798.
[29] B. L. Verges, J. P. Cercueil, D. Jacob, G. Vaillant, J. M. Brun and R. Putelat, “Results of Ultrasonically Guided Percutaneous Ethanol Injection into Parathyroid Adenomas in Primary Hyperparathyroidism,” The Lancet, Vol. 337, No. 8754, 1991, pp. 1421-1422. doi:10.1016/0140-6736(91)93115-P
[30] P. C. Chaffanjon, N. Cardin, O. Chabre and P. Y. Brichon, “Parathyroid Cyst,” Annales de Chirurgie, Vol. 126, No. 5, 2001, pp. 456-458. doi:10.1016/S0003-3944(01)00530-2

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