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Case Reports in Endocrinology
Volume 2014, Article ID 213283, 4 pages
http://dx.doi.org/10.1155/2014/213283
Case Report

A Case of Primary Hyperparathyroidism due to Intrathyroidal Parathyroid Cyst

1Department of Endocrinology and Metabolism, Ordu Training and Research Hospital, Ministry of Health, Ordu, Turkey
2Department of Endocrinology and Metabolism, Samsun Training and Research Hospital, Ministry of Health, Samsun, Turkey
3Department of General Surgery, Samsun Training and Research Hospital, Ministry of Health, Samsun, Turkey
4Department of Radiology, Samsun Training and Research Hospital, Ministry of Health, Samsun, Turkey
5Department of Pathology, Samsun Training and Research Hospital, Ministry of Health, Samsun, Turkey

Received 18 September 2014; Accepted 24 November 2014; Published 29 December 2014

Academic Editor: Takeshi Usui

Copyright © 2014 Yavuz Yalcin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Parathyroid cysts constitute 0.08–3.41% of all parathyroid masses. Intrathyroidal parathyroid cysts, however, are rare conditions with only a few cases being reported. Most of the parathyroid cysts are found to be nonfunctional and functional cysts are generally thought to be due to cystic degeneration of parathyroid adenomas. A cystic, smooth contoured lesion of 24 × 19 × 16 mm was observed in left thyroid lobe of a 76-year-old woman during ultrasonography which was performed as routine workup for primary hyperparathyroidism. It was defined as a cystic thyroid nodule at first. Tc99m sestamibi scintigraphy was performed to see any parathyroid lesions, but no radioactive uptake was observed. Intact parathormone (iPTH) level was found to be >600 pg/mL in cyst aspiration fluid. Left lobectomy was performed, with a diagnosis of primary hyperparathyroidism due to functional parathyroid cyst. Serum iPTH level was decreased >50% postoperatively and histopathological evaluation was consistent with an encapsulated parathyroid adenoma with a cystic center. Parathyroid cysts are among rare causes of primary hyperparathyroidism. Diagnosis is made by markedly increased iPTH level in cyst fluid and observation of parathyroid epithelium lining the cyst wall.