Coexistence of a parathyroid adenoma and parathyroid cyst causing primary hyperparathyroidism
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The association of a functional parathyroid cyst with a parathyroid adenoma is an uncommon finding. In this report we describe the clinical history of a 60-yr-old man, presenting with the following findings: hypercalcemia (18.9 mg/dl), elevated serum parathormone levels (1320 pg/dl), hypercalciuria (228 mg/dl), and hyperphosphaturia (155 mg/dl). Neck ultrasound, magnetic resonance imaging (MRI) and 99Tc Sestamibi scintigraphy led to the identification of a left parathyroid adenoma, located at the lower pole of the left thyroid gland lobe, associated with a parathyroid cyst, located at the upper extremity of the same thyroid lobe. Parathyroidectomy was performed and the histological examination confirmed the diagnosis of a parathyroid adenoma with aspects of cystic degeneration and an upper parathyroid cyst. Analysis of the cristal clear intracystic fluid showed elevated parathyroid hormone (PTH) levels (137.000 pg/ml). The patient is normocalcemic at 2 yr after surgery without signs of recurrent parathyroid enlargements. Aetiology, diagnosis and management of parathyroid cyst will be discussed.
Key-wordsHyperparathyroidism parathyroid adenoma parathyroid cyst
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- 2.Lack E.E., Clark M.A., Buck D.R., King D.R. Cysts of the parathyroid gland: report of two cases and review of the literature. Am. Surg. 1978, 5: 376–381.Google Scholar
- 3.Clandra D.B., Shah K.H., Prinz R.A., et al. Parathyroid cysts: a report of eleven cases including two associated with hyperparathyroid crisis. Surgery 1983, 94: 887–892.Google Scholar
- 4.Sandstrom I. Om en ny kortel hos menniskan och atskilliga daggdjur. Upsala Lakarforening Forhandlingr. 1880, 14: 441–471.Google Scholar
- 5.Goris D. Extirpation de trois lobules parathyroidens kystiques. J. Chir. Ann. Pathol. Soc. Belge 1905, 5: 394–396.Google Scholar
- 7.Forsyth D. The parathyroid glands. Q. J. Med. 1908, 1: 287–311.Google Scholar