Surgical treatment of parathyroid cysts: Case series and review of literature

Introduction. Parathyroid cysts are divided into two categories: functional and nonfunctional. Both types of parathyroid cysts, if they are large enough, can represent as mediastinal or neck mass in 1-5 %. Case series. We have analyzed data of the patients operated from 2016 till 2021 due to primary hyperparathyroidism or because of cervical/mediastinal mass. Review of patients demographic data, preoperative fine needle aspiration biopsy, level of parathyroid hormone in serum pre and postoperative, level of serum calcium, clinical presentation of disease was done. Total of 555 patients were operated in this period pathological confirmation of parathyroid gland. Parathyroid cysts were found in seven cases. In five cases cyst was nonfunctional. Four female and three male were operated due to parathyroid cyst. Mean age of operated patients was 49,8 years. In one patient nonfunctional cyst was represented with cervical and upper mediastinal mass with maximal diameter of 10 cm. Conclusion. Although parathyroid cysts represent around 0.5% of all parathyroid pathology it should be considered as preoperative diagnose especially if water like liquid is found with fine needle aspiration biopsy. Experience endocrine surgeon should perform operation with preserving cysts wall to avoid parathyreomatosis, and recurrent laryngeal nerve preserving.