Parathyroid Cysts (PC) 101 Natural History and Ethanol Ablation Treatment
Non-functioning PC is found in the thyroid bed or even in the thyroid gland. They are seen on detailed endocrine neck ultrasounds. The case above shows left inferior PC that is small. These incidental findings need no therapy while they are small. They can however hemorrhage and cause pain. FNA confirms the bleed and with high Parathyroid hormone PTH confirms the DX of PC. A bleed in a small PC needs no additional therapy. However larger PCs that bleed can be a problem. They can cause blood to descend into the chest cavity. If a large PC bleeds it is a candidate for ethanol ablation. PC can become quite large and cause symptoms and cosmetic factors requiring ethanol ablation.The classic clear fluid seen with a PC can be masked it there is a bleed. The color with look more like a thyroid cyst. Also large PCs can be located in the thyroid gland and look like a thyroid cyst. The use of needle washout for PTH can help separate thyroid cyst for PC.
The use of evacuation of the cyst fluid rarely works. One patient had 10 drainage procedures before coming to me for ethanol ablation.One injection cured the PC and removed the symptoms and cosmetic indications. The treatment of choice is ethanol ablation instead of the old way of removal by surgery.
Call me at 310-393-8860 or [email protected] for treatment for your thyroid or parathyroid cyst.
Richard Guttler MD.FACE,ECNU