Diagnostic Pitfalls on Parathyroid Gland Cyst (Case report)
Authors:
J. Lukáš 1,4; P. Prokopová 2; B. Hintnausová 3
Authors‘ workplace:
Oddělení ORL a chirurgie hlavy a krku Nemocnice Na Homolce, Praha
; přednosta prof. MUDr. J. Astl, CSc.
Oddělení patologie Nemocnice Na Homolce, Praha
1; přednosta prim. MUDr. M. Syrůček
Interna, endokrinologická ambulance Nemocnice Na Homolce, Praha
2; přednosta prim. MUDr. M. Čech
Klinika ORL LF UK v Plzni
3; přednosta doc. MUDr. J. Slípka, CSc.
4
Published in:
Otorinolaryngol Foniatr, 61, 2012, No. 3, pp. 195-197.
Category:
Case History
Overview
This case report draws attention to obstacles in the diagnosis of nonfunctional parathyroid gland cyst in simultaneous finding of polynodal (polynodular) struma. The female patient (68) was recommended to total thyroidectomy for growth progression of nodes in the left lobe of thyroid gland. Cytological finding, obtained by thin-needle aspiration biopsy navigated by ultrasound corresponded to regressive follicular changes. In addition to calcified nodes in the left lobe of thyroid gland a cavity was found under its lower pole, which contained protein matters without cellular detritus. In the course of thyroidectomy, a dark-colored formation of 19 x 7 x 5 mm in paratracheal position was extirpated. Macroscopic examination revealed a cystic appearance, thin wall and contained a brown liquid. Microscopic analysis of the whole preparation revealed hyperemic parathyroid gland tissue with regions of adult fat tissue. The cyst wall was formed by a layer of different thickness with occasional cicatricial changes or even hyalinized connective tissue and deposits of hematogenous pigments. The epithelium was flattened here and there and formed by cells with a pale cytoplasm with negative mucous formation. A negative immunohistochemical examination with the TTF1 antibody excluded the origin from thyroid gland. The conclusion of postoperative pathological examination gave evidence in favor of nodal colloidal struma and a cyst of parathyroid gland on the right
Key words:
parathyroid gland cyst, polynodal struma, thin-needle aspiration biopsy.
Sources
1. Atwan, M., Chetty, R.: An unsual „Thyroid cyst“: Intrathyroidal parathyroid Cyst. Endocr. Pathol., 22, 2011, s. 108-111.
2. Ippolito, G., Palazzo, F. F., Sebag, F., Sierra, M., De Micco, C., Henry, J. F.: A single-institution 25-year review of true parathyroid cysts. Langenbecks Arch. Surg., 391, 2006, s. 13-18.
3. Kato, H., Kanematsu, M.,. Kiryu, T., Iwata, H., Matsumoto, S., Hirose, Y. et al.: Nonfunctional mediastinal parathyroid cyst: imaging findings in two cases. Clinical Imaging, 32, 2008, 4, s. 310-313.
4. Mc Coy, K. L., Yim, J. H., Zuckerbraun, B. S., Ogilvie, J. B., Peel, R. L., Carty, S. E.: Cyst parathyroid lesions. Arch. Surg.., 144, 2009, 1, s. 52-56.
5. Mc Kay, G. D., Ng, T. H., Morgan, G. J., Chen, R. C.: Giant functioning parathyroid cyst presenting as a retrosternal goitre. ANZ J. Surg., 77, 2007, s. 297-304.
6. Mevio, E., Gorini, E., Sbrocca, M., Artesi, L., Mullace, M., Lecce, S.: Parathyroid cysts; description of two cases and review of the literature. Acta Otorhinolaryngol. Ital, 24, 2004, s. 161-164.
7. Nardi, C. E. M., da Silva, R. A., Serafim, C. M., Dedivitis, R. A.: Nonfunctional parathyroid cyst: case report. Sao Paulo Med. J., 127, 2009, 6, s. 382-384.
8. Ujiki, M. B., Nayar, R., Sturgeon, C., Angelos, P.: Parathyroid cysts; often mistaken for a thyroid cyst. World J. Surg., 31, 2007, s. 60-64.
9. Wani, S., Hao, Z.: Atypical cystic adenoma of the parathyroid gland: case report and review of literature. Endocr. Pract., 11, 2005, s. 389-393.
10. Wirowski, D., Wicke, C., Böhner, H., Lammers, B. J., Pohl, P., Schwarz, K. et al.: Presentation of 6 cases with parathyroid cysts and discussion of the literature. Exp. Clin. Endocrinol. Diabetes, 116, 2008, s. 501-506.
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2012 Issue 3
Most read in this issue
- Chronic Hypertrophic Rhinitis Resistant to Conservative Therapy – Comparison of Various Surgical Techniques of Mucotomy/Turbinoplasty (Including Economic Analysis)
- Effect of Facial Cleft Malformations of Middle Ear Disease
- Quality of Life in Patients with Extraesophageal Reflux
- Endoscopic Transnasal Surgery of Sellar Region