Unusual presentations of functional parathyroid cysts: a case series and review of the literature
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s13256-017-1502-1 |
| _version_ | 1818229436099592192 |
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| author | Youssef El-Housseini Martin Hübner Ariane Boubaker Jan Bruegger Maurice Matter Olivier Bonny |
| author_facet | Youssef El-Housseini Martin Hübner Ariane Boubaker Jan Bruegger Maurice Matter Olivier Bonny |
| author_sort | Youssef El-Housseini |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-12T10:18:34Z |
| format | Article |
| id | doaj.art-15dc9f20717241cf852490017420c972 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-12T10:18:34Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-15dc9f20717241cf852490017420c9722022-12-22T00:27:36ZengBMCJournal of Medical Case Reports1752-19472017-11-011111810.1186/s13256-017-1502-1Unusual presentations of functional parathyroid cysts: a case series and review of the literatureYoussef El-Housseini0Martin Hübner1Ariane Boubaker2Jan Bruegger3Maurice Matter4Olivier Bonny5Service of Nephrology and Hypertension, Lausanne University HospitalService of Visceral Surgery, Lausanne University HospitalService of Nuclear Medicine, Lausanne University HospitalService of Nephrology and Hypertension, Lausanne University HospitalService of Visceral Surgery, Lausanne University HospitalService of Nephrology and Hypertension, Lausanne University HospitalAbstract 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.http://link.springer.com/article/10.1186/s13256-017-1502-1HyperparathyroidismParathyroid cystPTHParathyroid hormoneCase report |
| spellingShingle | Youssef El-Housseini Martin Hübner Ariane Boubaker Jan Bruegger Maurice Matter Olivier Bonny Unusual presentations of functional parathyroid cysts: a case series and review of the literature Journal of Medical Case Reports Hyperparathyroidism Parathyroid cyst PTH Parathyroid hormone Case report |
| 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 | Hyperparathyroidism Parathyroid cyst PTH Parathyroid hormone Case report |
| url | http://link.springer.com/article/10.1186/s13256-017-1502-1 |
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