Primary hyperparathyroidism: Functioning hemorrhagic parathyroid cyst

✍ Scribed by Gooding, Gretchen A. W.; Duh, Quan-Yang

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 476 KB
• Volume: 25
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/(sici)1097-0096(199702)25:2<82::aid-jcu6>3.0.co;2-f

✦ Synopsis

This report details a previously undescribed sonographic appearance of a hormonally active, hemorrhagic, parathyroid cyst with a fluid/fluid interface.

CASE REPORT

A 58-year-old man presented with primary hyperparathyroidism. The serum calcium was 12 mg/ dL and the parathyroid hormone 129 pg/mL (normal 10-60 pg/ml). No masses were palpable in the neck.

Sonography of the neck was performed to determine the site of the suspected parathyroid adenoma. The examination, using a 7.5 MHz transducer (Quantum, Issaquah, Washington), was normal except for a 2.7 cm × 3 cm complex cystic mass in the left upper pole of the thyroid gland, which had a distinct hyperechoic/hypoechoic interface (arrow, Figure 1A supine, Figure 1B lateral) that moved when the patient changed from a supine position to a lateral position.

Aspiration of this lesion at surgery revealed a bloody aspirate (Figure 2). Pathologic examina