Symptomatic nonfunctioning parathyroid cysts: role of simple aspiration and ethanol ablation.
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.
- PEI is the treatment of choice for parathyroid cysts.2.
- 12 PCs in 12 patients from March 1997 to June 2010.
- PC was diagnosed if the aspirated fluid was clear colorless and showed an elevated parathyroid hormone (PTH) level.
- Ethanol ablation (EA) was performed for recurrent PCs.
- Simple aspirations were performed using 23-gauge needles.
- EAs using 18-gauge needles with 99% ethanol under ultrasound (US) guidance.
- Follow up was 19 months.
- Simple aspiration was successful in four patients.
- Eight recurrent cases, EA resulted in a significant decrease in volume
- Two cases of primary failure of EA was treated by repeat EA.
- No major complications occurred in any patient
- 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