Mediastinal parathyroid cyst with tracheal constriction

Umemori, Yoshiki; Makihara, Seiichiro; Kotani, Kazutoshi; Washio, Kazuhiro

doi:10.1007/bf02919671

Cited by 8 publications

(10 citation statements)

References 5 publications

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“…Mediastinal PC usually represent large structures (≥4 cm). [14][15][16] Additionally, unusual symptoms, such as vocal cord paralysis due to local compression on recurrent laryngeal nerve, [17][18][19] respiratory failure and jugular vein thrombosis due to a large mediastinal nonfunctioning PC, have been described. 20 Nonfunctioning PC can also be located inside the thyroid where they are discovered as an incidental finding after NA during the evaluation of a multinodular goiter or a solitary thyroid nodule.…”

Section: General Commentsmentioning

confidence: 99%

Diagnostic and therapeutic review of cystic parathyroid lesions

Pontikides¹,

Karras²,

Kaprara³

et al. 2012

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BAcKGrOUND: Parathyroid cysts (Pc) are uncommon entities in routine clinical practice. The vast majority are nonfunctioning and are commonly present as asymptomatic nodular cervical lesions. Pc should be considered in the differential diagnosis of an asymptomatic neck mass. Large Pc can manifest with compressive symptoms of the surrounding tissues. OBJEcTIVE: The aim of this study is to describe nine new cases of Pc and review the current literature regarding the clinical presentation, the aetiopathology, the diagnostic procedures, as well as the therapeutic approaches for this relatively rare clinical entity. METHODs-PATIENTs: We present nine new patients (7 females and 2 males) diagnosed with Pc, which in three were ectopic. The diagnosis of Pc was based on the elevated levels of PTH in the cysts fluid. six of the patients had nonfunctioning parathyroid lesions, while the other three had functioning ones. Patients with functioning Pc had elevated serum calcium and PTH levels. Five out of nine of the cases had no symptoms, while two patients had compressive symptoms and the other two had signs and symptoms of hypercalcaemia. Needle aspiration (NA) was performed in five out of six patients with nonfunctioning Pc. surgery was the treatment in all three patients with functioning Pc. rEsULTs: remission after NA was achieved in four out of five patients with non-functioning Pc (follow-up time: 17.7±2.3 months). In two of them, two and three aspirations were needed. One patient with nonfunctioning Pc submitted to surgery with no previous NA. Patients with functioning Pc maintained remission after surgery (mean follow-up time: 22.1±2.9 months). In one of them, a second surgery was performed due to the co-existence of an ectopic parathyroid adenoma. cONcLUsIONs: The diagnosis of a Pc can be established by finding high levels of PTH in the fluid collected by the aspiration of the cyst. PTH and ca levels in the serum can differentiate functioning from nonfunctioning Pc. The treatment of HORMONES 2012, 11(4):410-418 Review

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Section: General Commentsmentioning

confidence: 99%

Diagnostic and therapeutic review of cystic parathyroid lesions

Pontikides¹,

Karras²,

Kaprara³

et al. 2012

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“…( 5 ) Although there have been reports of cyst aspiration and sclerotherapy, this is not the recommended approach, which is why we did not perform it. In retrospect, however, it must be considered that, in the presence of severe airway obstruction, such as that described in our patient, the risk of this type of puncture would be reasonable in order to improve the ventilatory status until definitive treatment.…”

Section: To the Editormentioning

confidence: 99%

“…( 5 ) Apesar dos relatos de aspiração e escleroterapia do cisto, a conduta não é a prática recomendada, razão pela qual não a realizamos. Entretanto, em retrospecto, há de se ponderar que, na vigência de severa obstrução ventilatória, como a descrita em nosso paciente, o risco desse tipo de punção seria justificável no intuito de melhorar a condição ventilatória até o tratamento definitivo.…”

Section: Ao Editorunclassified

Mediastinal cyst as a cause of severe airway compression and dysphonia

et al. 2013

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“…PCs may be functioning or non-functioning. Nonfunctioning cysts encompass 90 % of cases and occur more commonly in females [13,14]. Functioning cysts usually affect males and are associated with primary HPT [13].…”

Section: Introductionmentioning

confidence: 99%

“…Although most PCs are orthotopic, ectopic localization is possible in the cervical region, including both the thyroid and thymus [15][16][17][18]. Mediastinal PCs are usually large (C4 cm), causing compressive symptoms such as dysphagia and dyspnea [13,19,20], at times mimicking retrosternal goitre [14]. Vocal cord paralysis due to compression on the recurrent laryngeal nerve [21][22][23], respiratory failure and jugular or innominate vein thrombosis have also been reported as complications [24].…”

Section: Introductionmentioning

confidence: 99%

Cystic parathyroid glands in MEN1: A rare entity?

et al. 2016

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Approximately 300 cases of sporadic parathyroid cyst (PCs) have been reported to date. Only two cases have been described in MEN1 so far. Detection by imaging could be challenging, especially in multiglandular primary hyperparathyroidism (HPT) and clinical outcome could be different. During the period 1990-2014, 71 MEN1 patients were operated for primary hyperparathyroidism in our centre. We report three cases of PCs in MEN1 patients affected by HPT, who underwent a total or subtotal parathyroidectomy with transcervical thymectomy. In our series, all three patients had an unsatisfactory postoperative course, at variance with the high percentage (over 90 %) of long-term success in MEN1 patients operated at our centre. One patient affected by cystic degeneration of all the four parathyroid glands reported persistent hypoparathyroidism, despite autografts of parathyroid tissue. For the other two cases, surgery failed to cure hyperparathyroidism, perhaps because of the presence of undetected ectopic parathyroid tissue. In the context of a multiglandular disease such as MEN1 syndrome, PCs seem rare but our experience shows about a 4 % incidence. Furthermore their presence, even in expert hands, could affect the preoperative identification of the parathyroid glands due to the difficult differential diagnosis between PC and other cystic lesions of the neck, and intraoperative detection of the glands as well as the postoperative outcome.

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Mediastinal parathyroid cyst with tracheal constriction

Cited by 8 publications

References 5 publications

Diagnostic and therapeutic review of cystic parathyroid lesions

Diagnostic and therapeutic review of cystic parathyroid lesions

Mediastinal cyst as a cause of severe airway compression and dysphonia

Cystic parathyroid glands in MEN1: A rare entity?

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