Abstract：Objective To investigate the clinical and pathological features of parathyroid cysts (PCs). Methods Retrospective study. Fifteen patients with pathologically confirmed PCs from November 2012 to November 2021 in Shaanxi Provincial People's Hospital were included. Among the patients, 8 were males and 7 were females. The patients were aged 31-65 years (median age 45 years), and all patients underwent PC resection. The clinical features, imaging features, and pathological features of the patients were summarized. Results Out of the 15 patients, 14 were found to have a neck mass during self-examination or physical examination, 1 had coughing as the first symptom, and none had other clinical manifestations. In all patients, preoperative serum calcium and phosphorus levels were within the normal range, and parathyroid hormone and thyroid function tests were normal. Twelve cases were located in the lower pole of the left or right lobe of the thyroid, 3 cases were located in the thyroid gland, 2 cases were located behind the sternum, and 1 case was located in the right level VI lymph node area. Ultrasound results showed cystic fluid dark areas in the neck with clear borders. CT scans revealed round thin-walled low-density shadows in the neck. However, enhanced scans showed no enhancement. The PCs were 1-7 cm in size with an average diameter of (4.33±1.47) cm. The cysts mostly contained colorless and clear liquid. Microscopically, the fibrous cyst wall showed extruded parathyroid glands in the form of nests and cords. The parathyroid tissue was mainly composed of chief cells and oncocytic cells. The immunohistochemical staining of parathyroid tissue was positive for Chromogranin-A and negative for thyroglobulin, thyroid transcription factor-1, and synaptophysin. Conclusion PCs are rare clinically. Their variable anatomical location and lack of specific clinical and imaging features make their preoperative diagnosis difficult. Their definite diagnosis mainly depends on pathological examination. The typical parathyroid tissue in the cyst wall is the main pathological feature, and immunohistochemistry can be used for differential diagnosis.
张巍, 刘慧通. 甲状旁腺囊肿的临床病理特征分析[J]. 中华解剖与临床杂志, 2022, 27(9): 646-650.
Zhang Wei, Liu Huitong. Analysis of clinicopathological features of parathyroid cyst. Chinese Journal of Anatomy and Clinics, 2022, 27(9): 646-650.
Cappelli C, Rotondi M, Pirola I, et al.Prevalence of parathyroid cysts by neck ultrasound scan in unselected patients[J]. J Endocrinol Invest, 2009,32(4):357-359. DOI: 10.1007/BF03345727.
[2]
Arduc A, Tutuncu YA, Dogan BA, et al.Parathyroid cysts[J]. Am Surg, 2015,81(4): E163-E165.
[3]
Demir AD.A review of parathyroid mass and patients with nonspecific complaints[J]. J Int Med Res, 2020,48(1):300060519827169. DOI: 10.1177/0300060519827169.
[4]
Coelho DH, Boey HP.Benign parathyroid cyst causing vocal fold paralysis: a case report and review of the literature[J]. Head Neck, 2006,28(6):564-566. DOI: 10.1002/hed.20391.
[5]
Grunberg WI, Domingo OH.Parathyroid cyst[J]. Am Surg, 2011,77(11): E256-E257.
[6]
Papavramidis TS, Chorti A, Pliakos I, et al.Parathyroid cysts: a review of 359 patients reported in the international literature[J]. Medicine (Baltimore), 2018,97(28):e11399. DOI: 10.1097/MD.0000000000011399.
Silva R, Cavadas D, Vicente C, et al.Parathyroid cyst: differential diagnosis[J]. BMJ Case Rep, 2020,13(10). DOI: 10.1136/bcr-2019-232017.
[9]
Marsot-Dupuch K, Levret N, Pharaboz C, et al.Congenital neck masses. Embryonic origin and diagnosis. Report of the CIREOL[J]. J Radiol, 1995,76(7):405-415.
[10]
Rossi ED, Revelli L, Giustozzi E, et al.Large non-functioning parathyroid cysts: our institutional experience of a rare entity and a possible pitfall in thyroid cytology[J]. Cytopathology, 2015,26(2):114-121. DOI: 10.1111/cyt.12153.
[11]
Moreau-Lenoir F, Gruyer X, François A, et al.Parathyroid cysts: reprot of 2 cases and review of the literature[J]. Ann Otolaryngol Chir Cervicofac, 2000,117(6):403-409.
[12]
Uehara A, Suzuki T, Yamamoto Y, et al.A functional parathyroid cyst from the hemorrhagic degeneration of a parathyroid adenoma[J]. Intern Med, 2020,59(3):389-394. DOI: 10.2169/internalmedicine.3319-19.
[13]
Pontikides N, Karras S, Kaprara A, et al.Diagnostic and therapeutic review of cystic parathyroid lesions[J]. Hormones (Athens), 2012,11(4):410-418. DOI: 10.14310/horm.2002.1372.
[14]
Sung JY, Baek JH, Kim KS, et al.Symptomatic nonfunctioning parathyroid cysts: role of simple aspiration and ethanol ablation[J]. Eur J Radiol, 2013,82(2):316-320. DOI: 10.1016/j.ejrad.2012.10.009.
[15]
Akel M, Salti I, Azar ST.Successful treatment of parathyroid cyst using ethanol sclerotherapy[J]. Am J Med Sci, 1999,317(1):50-52. DOI: 10.1097/00000441-199901000-00007.
[16]
肖楠, 叶新华, 刘圣, 等. 超声引导下无水乙醇消融治疗无功能性甲状旁腺囊肿的临床效果[J].广西医学,2019,41(13):1613-1615.Xiao N,Ye XH,Liu S,et al.Clinical efficacy of ultrasound-guided anhydrous ethanol ablation therapy for non-functional parathyroid cyst[J]. Guangxi Medical Journal,2019,41(13):1613-1615. DOI:10.11675/j.issn.0253-4304.2019.13.03.
[17]
Sánchez A, Carretto H.Treatment of a nonfunctioning parathyroid cyst with tetracycline injection[J]. Head Neck, 1993,15(3):263-265. DOI: 10.1002/hed.2880150317.
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