Benign parathyroid cyst causing vocal fold paralysis: a case report and review of the literature.
BACKGROUND
Parathyroid cysts are uncommon, frequently asymptomatic lesions of the neck and superior mediastinum. Symptomatic parathyroid cysts are very rare, with roughly only 200 cases reported in the literature. Of these, only nine cases have been reported with recurrent laryngeal nerve (RLN) paralysis


METHODS
We report a case of a 49-year-old man initially seen with a 6-month history of worsening hoarseness. Physical examination revealed a palpable 3-cm, firm, smooth, nontender mass of the right thyroid lobe. Fiberoscopic laryngoscopy showed right vocal cord immobility consistent with RLN paralysis. After CT and fine-needle aspiration of the mass, the patient underwent a right thyroid lobectomy. During surgery, the recurrent laryngeal nerve was found to be stretched and adherent to a right inferior lobe mass.


RESULTS
Histologic analysis of the surgical specimen revealed a benign parathyroid adenomatous cyst. Postoperatively, the patient's voice improved markedly. This case represents an extremely rare return of function of the RLN after cyst removal.


CONCLUSIONS
Parathyroid cysts should be included in the differential diagnosis for vocal fold paralysis.
Coelho
Daniel H
DH
Division of Otolaryngology, Yale University School of Medicine, 333 Cedar St., Box 208041, New Haven, CT 06520-8041, USA. snrug@yahoo.com
Boey
Howard P
HP
D003560:Cysts / Q000150:complications*; D005336:Fiber Optic Technology; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010279:Parathyroid Diseases / Q000150:complications*; D012009:Recurrent Laryngeal Nerve; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000209:etiology*