부갑상선 낭종의 진단적 접근 및 치료

• 영문명: Diagnostic Approach and Treatment for Parathyroid Cyst
• 발행기관: 대한내분비외과학회
• 저자명: 윤종호¹ 최선호 남기현 장항석 박정수 Jong Ho Yoon M.D.¹ Sun Ho Choi M.D. Kee-Hyun Nam M.D. Hang-Seok Chang M.D. and Cheong Soo Park M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』4권2호, 110~114쪽, 전체 5쪽
• 주제분류: 의약학 > 면역학
• 파일형태: PDF
• 발행일자: 2004.12.30

영문 초록

Purpose: Parathyroid cysts are rare clinical entities of the neck and superior mediastinum. These cysts often present a difficult diagnostic challenge. They often present as a solitary thyroid nodule and may be difficult to differentiate clinically. The objectives of this study were to review our 27 cases of parathyroid cyst and to suggest the method of diagnostic approach and treatment for parathyroid cyst. Methods: A retrospective study was performed for a 24-year period (1981∼2004), on 27 patients operated of parathyroid cyst. Results: Most of these patients (22/27) complained asymptomatic anterior neck mass at presentation. Preoperative radiologic examinations included ultrasonography (70.4%), computed tomography (25.9%), and ^99mTc thyroid scan (22.2%). Hypercalcemia was detected in 3 cases with high serum calcium (11.3 mg/dl) and intact PTH (158.1 pg/mL). Fine Needle Aspiration (FNA) was performed in nineteen cases. It revealed crystal clear aspirate in non-functioning cysts and hemorrhagic in functioning cysts. In the analysis of the aspirate, mean N-terminal PTH (n=10) and intact PTH (n=9) were 22.5 pg/mL (9.3∼45.0) and 686.5 pg/mL (138.0∼1500.0), respectively. Mean size of the cysts was 4.0 cm (1.0∼9.2) and the left inferior parathyroid glands were most commonly involved (63.0%). All parathyroid cysts were surgically removed. Conclusion: Parathyroid cysts need to be differentiated from other cystic lesions in the neck and superior mediastinum. Aspiration of crystal clear fluid is highly suggestive of a parathyroid cyst. The aspirate should be analyzed for PTH levels as these are always elevated in parathyroid cysts,regardless of the function. Nonfunctioning cysts may be treated with aspiration alone or sclerosing agents. Surgical excision is indicated for functioning cysts and recurrent case of nonfunctioning cysts. (Korean J Endocrine Surg 2004;4: 110-114)

키워드

부갑상선 낭종, 부갑상선 호르몬, 세침흡인,Parathyroid cyst, Parathyroid hormone, Fine Needle Aspiration