Endocrine Abstracts

The retrospective experience of diagnosis and treatment of 18 people with true parathyroid cysts was studied. Clinical features, ultrasound results, laboratory parameters, surgical aids and subsequent dynamics were studied. All patients were women aged 35 to 77 years. Parathyroid cysts had no clinical manifestations, hyperparathyroidism and compression syndrome were absent. All parathyroid cysts were discovered accidentally during an ultrasound examination of the neck. Often the reason for contacting surgeons was a referral to FNAB due to an erroneous diagnosis of thyroid nodules. Ultrasound data showed that all the cysts were located on the neck, two of them fell behind the collarbone. Most of the cysts (14) were located in the projection of the lower third of the thyroid lobes and below the thyroid gland. The cysts were visualized as rounded or oval formations with clear contours, an echogenic capsule, the absence of a solid component and anechoic contents with distal pseudo-amplification of the echo. Ultrasound criteria included cases of reliable location of cysts outside the thyroid gland, as well as a tendency to increase due to one of the diameters. When determining the size of cysts, their diameter ranged from 10 to 120 mm. Elevated levels of PTH and Ca⁺⁺ in the blood were not detected in any patient. In all cases, a crystal clear colorless liquid was obtained using FNAB, which was one of the diagnostic criteria. When determining the level of PTH in the cystic fluid, a very high (more than 1000 pg/ml) concentration of the hormone was observed in all cases. Cystectomy was performed in 4 cases together with thyroid surgery (thyroid adenomas and nodular goiter). In 10 cases (dimensions more than 30 mm (average volume more than 4 ml), sclerotherapy was performed), in 4 cases - aspiration of cystic contents. The results were tracked 3 months and 1 year after the manipulations. Since all parathyroid cysts were functionally inactive, PTH levels after aspiration, sclerotherapy and cystectomy were not determined. The level of Ca⁺⁺ in the blood after aspiration and sclerotherapy was not determined, and after surgery was measured 24 hours after the intervention. According to ultrasound and laboratory tests, a positive result was obtained in all cases. It was concluded that the presented protocol of examination and treatment of patients is optimal, and the choice of treatment method depends on the size and activity of cysts, as well as on the presence of concomitant pathology.