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Parathyroid cysts: report of the sixth and youngest pediatric case
J W Entwistle1, C V Pierce, D E Johnson
1Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298.
Insights
This case report details a nonfunctioning parathyroid cyst in an 8-year-old girl, the youngest reported. Diagnosis involves fluid aspiration and parathyroid hormone levels, with surgery recommended for persistent or recurrent cysts.
Area of Science:
- Pediatric Endocrinology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Parathyroid cysts are rare, typically asymptomatic, but can present with hyperparathyroidism symptoms.
- This report focuses on a nonfunctioning parathyroid cyst in a pediatric patient, highlighting a unique demographic.
- Understanding the diagnostic and management nuances of parathyroid cysts is crucial for clinical practice.
Observation:
- An 8-year-old female presented with a nonfunctioning parathyroid cyst, representing the youngest documented case.
- The cyst was located laterally in the neck.
- Diagnostic aspiration revealed clear fluid with elevated parathyroid hormone levels.
Findings:
- Aspiration of clear fluid with elevated parathyroid hormone confirmed the diagnosis of a parathyroid cyst.
- Initial aspiration led to cyst resolution without recurrence, indicating a conservative management approach was successful.
- The case underscores the importance of parathyroid hormone level assessment in cyst fluid analysis.
Implications:
- Nonfunctioning parathyroid cysts can be diagnosed and managed conservatively through fluid aspiration if asymptomatic.
- Recurrent or persistent cysts necessitate surgical intervention with careful parathyroid gland identification due to risks of hyperplasia or adenoma.
- This case expands the understanding of parathyroid cyst presentation in pediatric populations and reinforces diagnostic criteria.
Abstract:
A nonfunctioning parathyroid cyst occurred in an 8-year-old girl, the youngest patient reported to have this diagnosis. Most cysts are asymptomatic; a few are associated with signs and symptoms of hyperparathyroidism. In asymptomatic patients with a lateral neck cyst, aspiration of clear fluid with an elevated parathyroid hormone level is diagnostic of a parathyroid cyst. If this results in disappearance of the cyst, without recurrence, no further treatment is necessary. If the cyst recurs, aspiration may be repeated. However, persistence of the cyst despite aspiration or recurrence after the second aspiration should prompt surgical removal, with intraoperative identification of all parathyroid glands, because functioning parathyroid cysts are associated with a high risk of hyperplasia or adenoma.
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