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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.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|January 1, 1995
PubMed
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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.

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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.