Needle aspiration of nonfunctioning parathyroid cysts.
Until recently, nonfunctioning parathyroid cysts were usually identified at operation for a presumed thyroid mass. Thyroid needle biopsy now allows their preoperative diagnosis and potential definitive treatment. This study reviews four patients with nonfunctioning parathyroid cysts treated during a two-year period. Three women and one man range in age from 28 to 70 years. Each presented with an asymptomatic thyroid mass ranging from 3 to 5 cm in length. None had symptoms of primary hyperparathyroidism. Serum calciums were from 9.2 to 10.7 mg/dl and serum phosphoruses were 3.2 to 4.4 mg/dl. Needle aspiration revealed 5 to 85 cc of water-clear fluid. C-terminal parathyroid hormone in three patients was 12,600, 6,500 and 61,200 pg/ml and N-terminal PTH was 1,700 pg/ml in one. All four had normal serum calcium and phosphorus on follow-up ranging from six months to two years. Two patients had resolution of their cysts with a single aspiration. One patient had recurrence but has no evidence of recurrence six months after injection with tetracycline. Another patient had a recurrence but remains well one year following reaspiration. Nonfunctioning parathyroid cysts present as a thyroid mass. Needle aspiration of water-clear fluid high in parathormone is diagnostic and, in most patients, is the therapeutic modality of choice.
Prinz
R A
RA
Loyola University Stritch School of Medicine, Department of Surgery, Maywood, Illinois 60153.
Peters
J R
JR
Kane
J M
JM
Wood
J
J
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D002118:Calcium / Q000097:blood; D003560:Cysts / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D001239:Inhalation; D008297:Male; D008875:Middle Aged; D010279:Parathyroid Diseases / Q000473:pathology* / Q000628:therapy; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D012008:Recurrence; D013752:Tetracycline / Q000627:therapeutic use
D010281:Parathyroid Hormone; D010758:Phosphorus; D013752:Tetracycline; D002118:Calcium