Non-functional parathyroid cyst - diagnostic pitfall: A case-report

Introduction. Parathyroid cysts are relative rare and they may be misdiagnosed with thyroid nodules. Parathyroid cysts are characterized by elevated level of parathyroid hormone (PTH) in cystic fluid. Case report. We reported about middle-aged woman with palpable node in the left thyroid lo...

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Main Authors: Polovina Snežana P., Anđelković Zoran, Micić Dragan D.
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2015-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500103P.pdf
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author Polovina Snežana P.
Anđelković Zoran
Micić Dragan D.
author_facet Polovina Snežana P.
Anđelković Zoran
Micić Dragan D.
author_sort Polovina Snežana P.
collection DOAJ
description Introduction. Parathyroid cysts are relative rare and they may be misdiagnosed with thyroid nodules. Parathyroid cysts are characterized by elevated level of parathyroid hormone (PTH) in cystic fluid. Case report. We reported about middle-aged woman with palpable node in the left thyroid lobe. Ultrasound showed anechoic 40 ´ 25 mm lesion in the left thyroid lobe. Fine needle aspiration (FNA) obtained 13 mL colorless, watery cystic fluid. PTH value in cystic fluid was ten fold more in comparison with serum PTH. Serum PTH was slightly elevated, D vitamin was under the reference range, serum calcium and phosphorus were normal as well as thyroid hormones. Thyroglobulin antibodies (TgAb) and thyroid peroxidase antibodies (TPOAb) were not detected. Radionuclide parathyroid scintigraphy indicated at physiological metaiodbenzyl-guamidine (MIBG) distribution. After six months of vitamin D supplementation, serum calcium, phosphorus, vitamin D and PTH were normal. This finding was indicative that was a nonfunctional parathyroid cyst. Conclusion. This case report points out that thyroid cystic lesions with thin walls, and reverberation in ultrasound, must be observed as a potential parathyroid cyst. These cysts require caution during diagnostic aspiration because of danger of hypercalcemic crises due to FNA, which can be a life-threatening condition.
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spelling doaj-art-62aa6f7cfc144a81a02a29a364f819f62025-08-20T03:19:29ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202015-01-0172111032103410.2298/VSP140624103P0042-84501500103PNon-functional parathyroid cyst - diagnostic pitfall: A case-reportPolovina Snežana P.0Anđelković Zoran1Micić Dragan D.2Clinical Center of Serbia, Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Belgrade + Faculty of Medicine, BelgradeMilitary Medical Academy, Clinic for Endocrinology, BelgradeClinical Center of Serbia, Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Belgrade + Faculty of Medicine, BelgradeIntroduction. Parathyroid cysts are relative rare and they may be misdiagnosed with thyroid nodules. Parathyroid cysts are characterized by elevated level of parathyroid hormone (PTH) in cystic fluid. Case report. We reported about middle-aged woman with palpable node in the left thyroid lobe. Ultrasound showed anechoic 40 ´ 25 mm lesion in the left thyroid lobe. Fine needle aspiration (FNA) obtained 13 mL colorless, watery cystic fluid. PTH value in cystic fluid was ten fold more in comparison with serum PTH. Serum PTH was slightly elevated, D vitamin was under the reference range, serum calcium and phosphorus were normal as well as thyroid hormones. Thyroglobulin antibodies (TgAb) and thyroid peroxidase antibodies (TPOAb) were not detected. Radionuclide parathyroid scintigraphy indicated at physiological metaiodbenzyl-guamidine (MIBG) distribution. After six months of vitamin D supplementation, serum calcium, phosphorus, vitamin D and PTH were normal. This finding was indicative that was a nonfunctional parathyroid cyst. Conclusion. This case report points out that thyroid cystic lesions with thin walls, and reverberation in ultrasound, must be observed as a potential parathyroid cyst. These cysts require caution during diagnostic aspiration because of danger of hypercalcemic crises due to FNA, which can be a life-threatening condition.http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500103P.pdfparathyroid diseasescystsbiopsy, fine needlehypercalcemia
spellingShingle Polovina Snežana P.
Anđelković Zoran
Micić Dragan D.
Non-functional parathyroid cyst - diagnostic pitfall: A case-report
Vojnosanitetski Pregled
parathyroid diseases
cysts
biopsy, fine needle
hypercalcemia
title Non-functional parathyroid cyst - diagnostic pitfall: A case-report
title_full Non-functional parathyroid cyst - diagnostic pitfall: A case-report
title_fullStr Non-functional parathyroid cyst - diagnostic pitfall: A case-report
title_full_unstemmed Non-functional parathyroid cyst - diagnostic pitfall: A case-report
title_short Non-functional parathyroid cyst - diagnostic pitfall: A case-report
title_sort non functional parathyroid cyst diagnostic pitfall a case report
topic parathyroid diseases
cysts
biopsy, fine needle
hypercalcemia
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500103P.pdf
work_keys_str_mv AT polovinasnezanap nonfunctionalparathyroidcystdiagnosticpitfallacasereport
AT anđelkoviczoran nonfunctionalparathyroidcystdiagnosticpitfallacasereport
AT micicdragand nonfunctionalparathyroidcystdiagnosticpitfallacasereport