Nonfunctional mediastinal parathyroid cyst: imaging findings in two cases

Area of Science:

• Radiology
• Medical Imaging
• Endocrinology

Background:

• Parathyroid cysts are rare, often nonfunctional, and can occur in the mediastinum.
• Differentiating mediastinal cystic lesions can be challenging based solely on imaging.

Observation:

• Computed tomography (CT) and magnetic resonance (MR) imaging were used to evaluate two cases of nonfunctional mediastinal parathyroid cysts.
• Unenhanced CT revealed homogeneous water density areas.
• Unenhanced MRI demonstrated homogeneous areas isointense to cerebrospinal fluid.

Findings:

• The cysts were located posterior to the left thyroid lobe's lower pole, extending into the superior mediastinum.
• Imaging findings are nonspecific and can mimic other cystic lesions in the neck or mediastinum.
• Characteristic location posterior to the thyroid gland and extending into the mediastinum is key.

Implications:

• Radiologists should consider parathyroid cysts in the differential diagnosis of mediastinal cystic lesions.
• Characteristic imaging features, particularly location, can help identify these rare entities.
• Further investigation may be needed to confirm the diagnosis and rule out other pathologies.