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Elevated calcium level in parathyroid cyst fluid.
J W Burhop1, J M Cerletty, M J Demeure
1Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53211, USA.
Summary
Parathyroid cysts are rare neck masses. Diagnosis was confirmed by elevated cyst fluid calcium, despite normal parathormone levels, leading to surgical removal after recurrence.
Area of Science:
- Endocrinology
- Surgical Pathology
- Head and Neck Surgery
Background:
- Parathyroid cysts are infrequent causes of neck masses.
- Diagnosis typically relies on elevated parathormone in cyst fluid via fine needle aspiration.
- Atypical presentations can challenge standard diagnostic protocols.
Purpose of the Study:
- To report a case of parathyroid cyst diagnosed by elevated cyst fluid calcium.
- To highlight an alternative diagnostic marker when parathormone levels are inconclusive.
- To discuss management of recurrent parathyroid cysts.
Main Methods:
- Fine needle aspiration of neck mass.
- Biochemical analysis of cyst fluid, including calcium and intact parathormone levels.
- Surgical excision for recurrent cyst.
Main Results:
- Cyst fluid parathormone levels were normal.
- Elevated cyst fluid calcium level confirmed the diagnosis.
- The parathyroid cyst recurred after two aspiration attempts.
- Successful curative operative excision was performed.
Conclusions:
- Elevated cyst fluid calcium can aid in diagnosing parathyroid cysts with normal parathormone.
- Surgical excision may be necessary for recurrent or symptomatic parathyroid cysts.
- This case expands the diagnostic considerations for parathyroid cystic lesions.