Parathyroid No Surgery: Surgery is Not The Treatment of Choice for Non-Functioning Parathyroid Cysts.These are not the cause of hyperparathyroidism.

Parathyroid No Surgery: Surgery is Not The Treatment of Choice for Non-Functioning Parathyroid Cysts.These are not the cause of hyperparathyroidism.

Parathyroid No Surgery: Surgery is Not The Treatment of Choice for Non-Functioning Parathyroid Cysts.These are not the cause of hyperparathyroidism.
Eur J Radiol. 2013 Feb;82(2):316-20.

Symptomatic nonfunctioning parathyroid cysts: role of simple aspiration and ethanol ablation.

Eur J Radiol. 2013 Feb;82(2):316-20.
Large image of Fig. 1.

A 51-year-old man with PC. Axial US images of a parathyroid cyst with a largest diameter of 8.6 cm. (a) Before aspiration, a large PC below the left lower pole of the thyroid gland is noted. (b) Echogenic needle tip (arrow) can be seen in the cystic lumen during aspiration. T, trachea; C, common carotid artery.

Large image of Fig. 2.

A 42-year-old woman with PC. Axial US images of a parathyroid cyst with a largest diameter of 5.2 cm. (a) Recurred PC at 1 month after aspiration. (b) PC is filled with instilled ethanol via an 18-gauge needle (arrow) after complete evacuation of the cystic fluid. T, trachea; C, common carotid artery.

  1. PEI is the treatment of choice for parathyroid cysts.2.
  2. 12 PCs in 12 patients from March 1997 to June 2010.
  3. PC was diagnosed if the aspirated fluid was clear colorless and showed an elevated parathyroid hormone (PTH) level.
  4. Ethanol ablation (EA) was performed for recurrent PCs.
  5. Simple aspirations were performed using 23-gauge needles.
  6. EAs using 18-gauge needles with 99% ethanol under ultrasound (US) guidance.
  7. Follow up was 19 months.
  8. Simple aspiration was successful in four patients.
  9.  Eight recurrent cases, EA resulted in a significant decrease in volume
  10.  Two cases of primary failure of EA was treated by repeat EA.
  11. No major complications occurred in any patient
  12. For symptomatic nonfunctioning PCs, simple aspiration could be a first line procedure for diagnosis and treatment, while EA can be a subsequent treatment modality for recurrent cases.

If you have a non-functioning parathyroid cyst do not consider surgery unless it’s associated with hyperparathyroidism.

Call me at 1310-393-8860 for details for ethanol ablation.

Richard Guttler MD,FACE,ECNU

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