Parathyroid cyst: current diagnostic and management principles.

BACKGROUND

Parathyroid (PTH) cyst is a rare lesion. Only about 200 cases have been reported to date. The diagnosis of a PTH cyst is difficult, particularly in its differentiation from thyroid cyst. It has clinical significance because PTH cysts can mimic a thyroid mass and can be associated with hyperparathyroidism.

METHODS

This presentation illustrates an additional case of a PTH cyst. The importance of fine-needle aspiration (FNA) in the diagnosis of PTH cyst and its management are discussed.

RESULTS

Fine-needle aspiration of clear fluid containing an elevated PTH hormone level proved to be diagnostic in the patient. Recurrence of the cyst after FNA required surgical resection. The current concepts of etiology and treatment are summarized.

CONCLUSIONS

PTH cyst should be in the differential diagnosis in any patient initially seen with an anterior cystic neck mass. Radiologic imaging and FNA can accurately diagnose PTH cysts. Surgical excision may be needed for recurrent cysts after aspiration.