A single-institution 25-year review of true parathyroid cysts

Abstract

PCs are rare but should be included within the differential diagnosis of a neck lump. True PCs are non-functional. Pathological and immunohistochemical findings are suggestive of a branchial origin. Fine-needle aspiration may be curative and is diagnostic due to the characteristic appearance of the fluid and high PTH levels on assay.

Nonfunctional parathyroid cyst: case report

“…3 Fine-needle aspiration under ultrasound guidance with cystic fluid assay for parathyroid hormone levels represents the approach of choice for both diagnosis and the initial treatment, since this is safe, easy and repeatable. 1 This method is more effective on nonfunctioning cysts. 3 Intracystic tetracycline injection may also be used on patients with recurrence; however, this has been associated with neck pain, neurotoxicity and recurrent nerve palsy due to leakage of the sclerosing agents through the disrupted thin cyst wall.…”

“…3 On radioiodine thyroid scans, parathyroid cysts appear as areas of absent uptake. 1 Computed axial tomography scan and magnetic resonance imaging may be indicated when there is a solitary neck mass that is not diagnosed by other methods. 3 Percutaneous needle aspiration of parathyroid cysts reveals crystal-clear fluid, which is highly suggestive of the diagnosis.…”

“…3 Intracystic tetracycline injection may also be used on patients with recurrence; however, this has been associated with neck pain, neurotoxicity and recurrent nerve palsy due to leakage of the sclerosing agents through the disrupted thin cyst wall. 1 Surgical excision appears to be the treatment of choice for functioning parathyroid cysts 3 and in cases of repeated recurrence. 1 Complications caused by removal of parathyroid cysts include hypocalcemia, hemorrhage, hypercalcemic crises, tetany and recurrent laryngeal nerve palsy.…”

“…It has been reported that they occur in 0.5% of parathyroid disease cases and represent 1% of all cystic lesions of the neck. 1 In 1880, Sandstrom reported the first parathyroid cyst. 2 These cysts commonly occur in the fourth and fifth decades of life, 3 with a female to male ratio of 2.5:1.…”

“…2 These cysts commonly occur in the fourth and fifth decades of life, 3 with a female to male ratio of 2.5:1. 1 The inferior parathyroid glands are most commonly involved, with left-sided predominance. Parathyroid cysts may be functional or nonfunctional, depending on their association with hypercalcemia.…”