Page G V, Burke M L, Metzger W T
Am Surg. 1984 Jan;50(1):29-32.
Parathyroid cysts are a rare cause of primary hyperparathyroidism. A case is presented of a 25-year-old black man who presented with hyperparathyroidism and at operation was found to have a 2.5 cm parathyroid cyst at the left inferior position. The cyst contained clear fluid, and the wall was thickened and composed of hyperplastic parathyroid tissue. The remaining glands were smaller but also hyperplastic. Subtotal parathyroidectomy was performed. This case presents many of the typical features of parathyroid cysts. The pertinent literature is reviewed. Parathyroid cysts present as two distinct groups, functioning and nonfunctioning. The former are more common in men, and the cyst is more likely to be secondary to degenerative changes in a hyperplastic gland. In contrast, nonfunctioning parathyroid cysts are more common in women and present as neck masses or incidental findings at operation. The different proposed etiologies for parathyroid cysts are discussed. Preoperative diagnosis is rare but important as it may prevent an unnecessary neck exploration or thyroidectomy. The diagnosis should be suspected with any cystic neck mass that yields clear fluid on aspiration, especially if it is in the inferior position. The fluid should be submitted for parathormone evaluation. Aspiration alone has been curative in some cases.
甲状旁腺囊肿是原发性甲状旁腺功能亢进症的一种罕见病因。本文报告一例25岁黑人男性，因甲状旁腺功能亢进症就诊，手术时发现左下方有一个2.5厘米的甲状旁腺囊肿。囊肿内含有清亮液体，囊壁增厚，由增生的甲状旁腺组织构成。其余甲状旁腺较小，但也呈增生状态。遂行甲状旁腺次全切除术。该病例呈现出甲状旁腺囊肿的许多典型特征。本文对相关文献进行了综述。甲状旁腺囊肿分为两种不同类型，即功能性和非功能性。前者在男性中更为常见，囊肿更可能继发于增生性腺体的退行性改变。相比之下，非功能性甲状旁腺囊肿在女性中更为常见，表现为颈部肿块或手术中的偶然发现。文中讨论了甲状旁腺囊肿不同的病因假说。术前诊断虽罕见但很重要，因为它可避免不必要的颈部探查或甲状腺切除术。对于任何抽吸时抽出清亮液体的颈部囊性肿块，尤其是位于下方者，均应怀疑有甲状旁腺囊肿，抽出的液体应送检甲状旁腺激素评估。在某些情况下，单纯抽吸即可治愈。
