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Coexistence of a parathyroid adenoma and parathyroid cyst causing primary hyperparathyroidism

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Abstract

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.

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Authors and Affiliations

  1. Institute of Surgical Semeiothic, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168, Rome, Italy

    G. Ardito,  Pietro Modugno, L. Revelli & F. Ardito

  2. Institute of Pathological Anatomy, Catholic University of Sacred Heart, Rome, Italy

    G. Fadda

  3. Service of Endocrinology, Italian Air Force Health Service, Rome, Italy

    D. Danese

  4. Institute of Radiology - Service of Nuclear Medicine, Rome, Italy

    A. Giordano

  5. Institute of Medical Pathology, Catholic University of Sacred Heart and Molecular Oncogenesis Laboratory, Regina Elena Cancer Institute, Rome, Italy

    A. Pontecorvi

Authors
  1. G. Ardito
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  2. G. Fadda
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  3. D. Danese
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  4. Pietro Modugno
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  5. A. Giordano
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  6. L. Revelli
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  7. F. Ardito
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  8. A. Pontecorvi
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Corresponding author

Correspondence to Pietro Modugno.

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Ardito, G., Fadda, G., Danese, D. et al. Coexistence of a parathyroid adenoma and parathyroid cyst causing primary hyperparathyroidism. J Endocrinol Invest 26, 679–682 (2003). https://doi.org/10.1007/BF03347029

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  • DOI: https://doi.org/10.1007/BF03347029

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