Ectopic intrathyroidal nonfunctioning parathyroid cyst.
OBJECTIVE
To describe a rare case of ectopic intrathyroidal parathyroid cyst (PC) in a 29-year-old woman who had been referred to us because of a multinodular goiter.


METHODS
We review the clinical, laboratory, and radiographic findings as well as the treatment in our patient and provide a brief discussion of the associated literature.


RESULTS
Ultrasonography of the neck showed the presence of 2 thyroid nodules in the left lobe, the larger of which was solid and the smaller of which had a cystic appearance. A small nodular area was also found in the right thyroid lobe (diameter, less than 8 mm). A thyroid scan performed with technetium showed the absence of uptake by both left lobe nodules. Fine-needle aspiration biopsy (FNAB) of the 2 major nodular lesions revealed that the larger thyroid nodule was benign and the smaller was a cyst with clear fluid. Measurement of parathyroid hormone in the FNAB fluid showed a high concentration, suggestive of the diagnosis of PC. Normal serum levels of parathyroid hormone and calcium indicated that it was a nonfunctioning intrathyroidal PC. The PC disappeared after FNAB, but the lesion recurred 3 months later. Therefore, the patient underwent near-total thyroidectomy. Histologic examination confirmed the diagnosis of intrathyroidal PC, and a papillary microcarcinoma (6 mm in diameter) was found in the right lobe of the thyroid.


CONCLUSIONS
Although an ectopic intrathyroidal PC is rare, the frequency of occult papillary microcarcinoma of the thyroid is high. The association we describe, however, should be considered incidental. To our knowledge, this is the first report of an association of an intrathyroidal PC with papillary microcarcinoma of the thyroid.
Capezzone
Marco
M
Unit of Endocrinology, Hospital of Tinchi-Pisticci, Matera, Italy.
Morabito
Eugenia
E
Bellitti
Pasquale
P
Giannasio
Paolo
P
de Santis
Domenico
D
Bruno
Rocco
R
D000231:Adenocarcinoma, Papillary / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D044963:Biopsy, Fine-Needle; D003560:Cysts / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D010279:Parathyroid Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D016606:Thyroid Nodule / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography