ECE2023 Eposter Presentations Calcium and Bone (99 abstracts)
A rare etiology of primary hyperparathyroidism
Houas Jihene 1 , Bergaoui Emna 1 , Ghammam Monia 1 , Naouar Maroua 1 , El Omri Malika 1 , Bellakhdher Mouna 1 , Hasni El Abed Yosra 2 , Meherzi Abir 1 , Kermani Wassim 1 & Abdelkefi Mohamed 1
1ENT Department and Neck Surgery of Farhat Hached Hospital, Sousse, Tunisia; 2Endocrinology department Farhat Hached Hospital, Sousse, Tunisia
Introduction: Parathyroid cysts are a rare clinical and histological entity, with less than 300 cases reported in the literature. They constitute 0.5% of all parathyroid pathologies and 1% of all cystic lesions in the cervical region. Parathyroid cysts can give rise to a varied symptomatology by the local or hormonal repercussions.
Case: We report the case of a 65-year-old patient with no pathological history who presented for bone pain with functional impotence of the lower limbs. Cervical examination noted a right basicervical tumefaction of 1.5 cm that is firm and mobile on swallowing. The biological assessment objectified an hypercalcemia at 2.43 with an hyperparathyroidism at 2406 pg/ml. Ultrasound evocated 2 necrotic lower lobe thyroid nodules. The parathyroid scintigraphy doesn’t show any fixation. Cervical scan showed a cystic lesion at the level of the lower part of the right thyroid lobe and another heterogeneous one on the left side. A para thyroidectomy of the lower right parathyroid gland, which had a large cystic component, was performed associated with left para thyroidectomy. Histopathological examination revealed a right lower parathyroid cyst with hyperplasia of the parathyroid parenchyma of both parathyroid glands. Postoperative follow-up showed a normalization of the calcium and parathyroid hormone levels.
Conclusion: Parathyroid cycts often involved the lower parathyroid glands, with a predominance on the left side. They can be functional or non-functional, depending on their association with hypercalcemia. The clinical manifestations are various. Some cases of carcinoma arising from parathyroid cysts have been reported suggesting that the surgical removal of all cysts should be strongly considered.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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