Coexistence of a parathyroid adenoma and parathyroid cyst causing primary hyperparathyroidism.
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 crystal 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.
Institute of Surgical Semeiothic, Catholic University of Sacred Heart, Rome, Italy.
G
G
Ardito
G
G
Fadda
D
D
Danese
P
P
Modugno
A
A
Giordano
L
L
Revelli
F
F
Ardito
A
A
Pontecorvi
D000236:Adenoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002118:Calcium / Q000097:blood; D003560:Cysts / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010279:Parathyroid Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D016105:Parathyroidectomy; D011877:Radionuclide Imaging
D002118:Calcium