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Unusual presentations of functional parathyroid cysts: a case series and review of the literature

BACKGROUND: Cysts of parathyroid origin are sometimes encountered and can easily be mistaken as thyroidal cysts. Functional parathyroid cysts, with symptoms and signs of hyperparathyroidism, are rare and may be a diagnostic challenge to clinicians. We report here on three cases of functional parathy...

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Autores principales: El-Housseini, Youssef, Hübner, Martin, Boubaker, Ariane, Bruegger, Jan, Matter, Maurice, Bonny, Olivier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706151/
https://www.ncbi.nlm.nih.gov/pubmed/29183364
http://dx.doi.org/10.1186/s13256-017-1502-1
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author El-Housseini, Youssef
Hübner, Martin
Boubaker, Ariane
Bruegger, Jan
Matter, Maurice
Bonny, Olivier
author_facet El-Housseini, Youssef
Hübner, Martin
Boubaker, Ariane
Bruegger, Jan
Matter, Maurice
Bonny, Olivier
author_sort El-Housseini, Youssef
collection PubMed
description BACKGROUND: Cysts of parathyroid origin are sometimes encountered and can easily be mistaken as thyroidal cysts. Functional parathyroid cysts, with symptoms and signs of hyperparathyroidism, are rare and may be a diagnostic challenge to clinicians. We report here on three cases of functional parathyroid cysts that illustrate diagnosis difficulties related to unusual clinical presentations in three Caucasian women, including negative parathyroid scintigraphy. CASE PRESENTATIONS: Patient 1, an 87-year-old Caucasian woman presented with confusion and dysphagia. She had hypercalcemia and elevated parathyroid hormone levels suggesting primary hyperparathyroidism. Parathyroid scintigraphy did not reveal any focal uptake, but a computed tomography scan of her neck identified a large cyst in the upper right thyroid region. At cervicotomy, a parathyroid cystic adenoma was removed. Patient 2, a 31-year-old Caucasian woman was investigated after a hypertensive crisis related to primary hyperparathyroidism. Cervical ultrasound identified a large cystic lesion in the lower left thyroid lobe that was removed by minimally invasive cervicotomy. Patient 3, a 34-year-old Caucasian woman presented with an indolent growing mass of the neck and a past medical history of kidney stones. Primary hyperparathyroidism was diagnosed. Ultrasound showed a cystic mass, but parathyroid scintigraphy was negative. Cervical exploration revealed a large cystic adenoma, containing high parathyroid hormone levels. CONCLUSIONS: Diagnosis of functional parathyroid cysts can be challenging due to various clinical presentations and negative parathyroid scintigraphy. Surgery, but not fine-needle sclerotherapy, appears to be the safest treatment option. Despite its rarity, differential diagnosis of cystic lesion of the neck should include primary hyperparathyroidism due to functional parathyroid cysts.
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spelling pubmed-57061512017-12-05 Unusual presentations of functional parathyroid cysts: a case series and review of the literature El-Housseini, Youssef Hübner, Martin Boubaker, Ariane Bruegger, Jan Matter, Maurice Bonny, Olivier J Med Case Rep Case Report BACKGROUND: Cysts of parathyroid origin are sometimes encountered and can easily be mistaken as thyroidal cysts. Functional parathyroid cysts, with symptoms and signs of hyperparathyroidism, are rare and may be a diagnostic challenge to clinicians. We report here on three cases of functional parathyroid cysts that illustrate diagnosis difficulties related to unusual clinical presentations in three Caucasian women, including negative parathyroid scintigraphy. CASE PRESENTATIONS: Patient 1, an 87-year-old Caucasian woman presented with confusion and dysphagia. She had hypercalcemia and elevated parathyroid hormone levels suggesting primary hyperparathyroidism. Parathyroid scintigraphy did not reveal any focal uptake, but a computed tomography scan of her neck identified a large cyst in the upper right thyroid region. At cervicotomy, a parathyroid cystic adenoma was removed. Patient 2, a 31-year-old Caucasian woman was investigated after a hypertensive crisis related to primary hyperparathyroidism. Cervical ultrasound identified a large cystic lesion in the lower left thyroid lobe that was removed by minimally invasive cervicotomy. Patient 3, a 34-year-old Caucasian woman presented with an indolent growing mass of the neck and a past medical history of kidney stones. Primary hyperparathyroidism was diagnosed. Ultrasound showed a cystic mass, but parathyroid scintigraphy was negative. Cervical exploration revealed a large cystic adenoma, containing high parathyroid hormone levels. CONCLUSIONS: Diagnosis of functional parathyroid cysts can be challenging due to various clinical presentations and negative parathyroid scintigraphy. Surgery, but not fine-needle sclerotherapy, appears to be the safest treatment option. Despite its rarity, differential diagnosis of cystic lesion of the neck should include primary hyperparathyroidism due to functional parathyroid cysts. BioMed Central 2017-11-29 /pmc/articles/PMC5706151/ /pubmed/29183364 http://dx.doi.org/10.1186/s13256-017-1502-1 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
El-Housseini, Youssef
Hübner, Martin
Boubaker, Ariane
Bruegger, Jan
Matter, Maurice
Bonny, Olivier
Unusual presentations of functional parathyroid cysts: a case series and review of the literature
title Unusual presentations of functional parathyroid cysts: a case series and review of the literature
title_full Unusual presentations of functional parathyroid cysts: a case series and review of the literature
title_fullStr Unusual presentations of functional parathyroid cysts: a case series and review of the literature
title_full_unstemmed Unusual presentations of functional parathyroid cysts: a case series and review of the literature
title_short Unusual presentations of functional parathyroid cysts: a case series and review of the literature
title_sort unusual presentations of functional parathyroid cysts: a case series and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706151/
https://www.ncbi.nlm.nih.gov/pubmed/29183364
http://dx.doi.org/10.1186/s13256-017-1502-1
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