scholarly journals Intrathyroidal Parathyroid Cyst: An Unusual Neck Mass

2017 ◽  
Vol 10 ◽  
pp. 117955141769813 ◽  
Author(s):  
Maswood M Ahmad ◽  
Mohammed Almohaya ◽  
Mussa H Almalki ◽  
Naji Aljohani
Keyword(s):  
Thyroid Tissue ◽  
Parathyroid Tissue ◽  
Rare Condition ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Maximum Diameter ◽  
High Concentration ◽  
Clear Fluid ◽  
Parathyroid Cyst ◽  
Parathyroid Dysfunction

Parathyroid cyst (PC) is a very rare condition. A case of intrathyroidal PC is being reported here in a 53-year-old woman who presented to the endocrine clinic with slowly progressive painless left anterior neck swelling for 1 year with no symptoms of thyroid or parathyroid dysfunction and no compressive symptoms. Ultrasound of the thyroid showed a well-defined cystic lesion measuring 4.7 × 3.6 cm in maximum diameter with internal echoes within the cyst located in the left lobe of the thyroid gland. Fine needle aspiration revealed colorless clear fluid with a high concentration of parathyroid hormone. The patient underwent left hemithyroidectomy at her request. Histopathology revealed parathyroid tissue with unilocular cyst and thyroid tissue with goitrous changes. She was in remission, and there was no evidence of thyroid or parathyroid dysfunction after surgery.

ONCOCYTIC INTRATHYROID PARATHYROID ADENOMA MASQUERADING AS HURTHLE CELL NEOPLASM: FINE NEEDLE ASPIRATION CYTOLOGY OF TWO CASES

2021 ◽  
pp. 57-58
Author(s):  
Mega Lahori ◽  
Hua Chen
Keyword(s):  
Parathyroid Adenoma ◽  
Thyroid Tissue ◽  
Parathyroid Tissue ◽  
Needle Aspiration ◽  
Thyroid Lobe ◽  
Cell Adenoma ◽  
Hürthle Cell ◽  
Hypoechoic Nodule ◽  
Left Thyroid Lobe ◽  
Pth Level

Ectopic parathyroid adenomas in thyroid tissue are uncommon (0.7 - 6%), and their oncocytic variants are exceedingly rare. We report two cases of intrathyroid parathyroid adenoma which were diagnosed as Hurthle cell adenoma on cytology. Case 1 is a 49-year-old female with a 2.4 cm hypoechoic nodule in the left lateral neck. Electrochemiluminescent immunoassay of the aspirate revealed PTH level of 422 pg/ml, conrming the presence of hyperfunctional parathyroid tissue. Subsequent resection of the left thyroid lobe revealed an enlarged intrathyroidal parathyroid. Case 2 is a 58-year-old female with a 2.1 cm hypoechoic nodule in the posterior-mid left thyroid lobe. Strong overexpression of parathyroid hormone and Chromogranin A genes and low expression of thyrocyte-related genes suggested parathyroid origin of the cells sampled. MEN1 mutation and multiple copy number alterations indicated the neoplastic nature of the nodule. Parathyroid oxyphil cells and oncocytic thyrocytes share cytomorphological ndings and distinguishing them by cytology alone is challenging, especially when the targeted lesion is intrathyroidal. Distinguishing intrathyroid oncocytic parathyroid adenoma from oncocytic thyroid follicular lesions has signicant clinical implications as Bethesda-IV category lesions have 20%–30% risk of malignancy. While stippled chromatin or intracytoplasmic fat vacuoles may be suggestive of parathyroid origin, these are not specic. Classifying the origin of a nodule as parathyroid vs thyroid rests upon the detection of PTH in aspirate material by ECL, immunocytochemistry or next-generation sequencing. In parathyroid aspirates, PTH level 100 pg/mL is suggestive of the presence of PTH-secre ≥ ting tissue at the site biopsied or along the needle track.

scholarly journals An Unusual Neck Mass: A Case of a Parathyroid Cyst and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Anand Goomany ◽  
Amy Rafferty ◽  
Ian Smith
Keyword(s):  
Imaging Techniques ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Review Of The Literature ◽  
Diagnostic Challenge ◽  
Anterior Neck ◽  
Cystic Fluid ◽  
Parathyroid Cyst ◽  
Parathyroid Cysts

Parathyroid cysts (PC) are an unusual cause of neck swellings. The majority are nonfunctioning and prove to be a diagnostic challenge given their nonspecific physical and radiological characteristics. This is compounded by their rare occurrence, leading them to be overlooked in the differential diagnosis of neck lumps. Imaging techniques fail to determine the origin of these lesions, but a preoperative diagnosis can be achieved by fine-needle aspiration and measurement of cystic fluid C-terminal parathyroid hormone levels. Treatment of nonfunctioning cysts remains controversial and includes needle aspiration, injection of sclerosant, or surgical excision. We present a case of a 44-year-old female presenting with an asymptomatic anterior neck swelling, diagnosed postoperatively as a parathyroid cyst.

scholarly journals A Killian-Jaimeson Diverticulum Masquerading as a Thyroid Nodule

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A914-A914
Author(s):  
Reema Patel ◽  
Maha Abdulla ◽  
Jianyu Rao ◽  
Abemayor Elliot ◽  
Dianne Cheung
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Tissue ◽  
Disease Process ◽  
Neck Surgery ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Care Physician ◽  
Pathology Report ◽  
Left Neck ◽  
Foreign Materials

Abstract Background: A Killian-Jaimeson diverticulum is a rare outpouching in the cervical esophagus, just below the cricopharyngeus muscle, that can be easily mistaken for a thyroid nodule on ultrasonography (1). Clinical Case: A 65-year-old woman underwent a thyroid ultrasound after her primary care physician noted left-sided thyromegaly. The ultrasound described a 33 mm solid, hypoechoic, wider-than-tall nodule in the left mid gland with an obscured posterior margin as well as macro- and microcalcifications. Given the size and highly suspicious features on ultrasound, she was referred to endocrinology clinic for a fine needle aspiration (FNA). She underwent ultrasound-guided FNA of what appeared to be the previously described thyroid nodule. Surprisingly, the pathology report noted degenerative changes with amorphous debris and possible foreign materials (vegetable or food) without any thyroid tissue. She was sent for an MRI neck, which showed the left neck mass communicating with the esophagus, favoring a left lateral projecting Killian-Jamieson esophageal diverticulum with internal debris. She was referred to head and neck surgery. Given only minimal symptoms of dysphagia, there are no current plans for surgery. Conclusion: This case illustrates the possibility of mistaking a Killian-Jaimeson diverticulum as a thyroid nodule. Recognition of this rare disease process in the differential diagnosis of thyroid nodules with high risk ultrasound characteristics may prompt more advanced imaging with MRI or CT, and lead to an accurate diagnosis prior to subjecting patients to unnecessary and potentially harmful FNAs (2). References: (1) Kim HK, Lee JI, Jang HW, et al. Characteristics of Killian-Jamieson diverticula mimicking a thyroid nodule. Head Neck. 2012;34(4):599-603. doi:10.1002/hed.21575. (2) Bonacchi G, Seghieri M, Becciolini M. Killian-Jamieson diverticulum: real-time sonographic findings. J Ultrasound. 2016;19(4):295-298. Published 2016 Apr 21. doi:10.1007/s40477-016-0208-3.

Ultrasonically Guided Fine Needle Aspiration of Suggested Enlarged Parathyroid Glands

1988 ◽  
Vol 29 (2) ◽  
pp. 213-216 ◽  
Author(s):  
S. Karstrup ◽  
A. Glenthøj ◽  
S. Torp-Pedersen ◽  
L. Hegedüs ◽  
H. H. Holm
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Tissue ◽  
Parathyroid Tissue ◽  
Needle Aspiration ◽  
Parathyroid Glands ◽  
Histologic Examination ◽  
Fine Needle

Ultrasonically guided fine needle aspiration from 22 ultrasonically suspect enlarged parathyroid glands was performed in 21 consecutive patients with biochemically confirmed hyperparathyroidism. Histologic examination revealed parathyroid tissue in 20 and thyroid tissue in 2 of the 22 ultrasonically suspect parathyroid glands. The aspirated material (21 patients) was analysed for PTH content and compared with the PTH content in aspirates from corresponding thyroid tissue. In all but one, a higher PTH content was found in aspirates from parathyroid glands. Further, the aspirated material (16 patients) was cytologically examined for parathyroid cells. In 10 of 14 histologically confirmed parathyroid glands cells of parathyroid origin were found, but in 4 cases only cells of endocrine origin were seen. The results and the use of fine needle aspiration in relation to the ultrasonic findings are discussed.

scholarly journals Chronic thyroiditis in lateral ectopic thyroid mimicking cervical metastasis of thyroid cancer

2021 ◽  
Vol 2021 ◽  
Author(s):  
Simone Pederzoli ◽  
Tiziana Salviato ◽  
Francesco Mattioli ◽  
Gianluca Di Massa ◽  
Giulia Brigante
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Frozen Section ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Ectopic Thyroid ◽  
Ultrasound Guided ◽  
Chronic Thyroiditis ◽  
Cervical Mass ◽  
Ectopic Thyroid Tissue

Summary We present the case of a 45-year-old Caucasian woman who attended the Endocrinology Unit for a left cervical mass discovered during follow-up for autoimmune chronic thyroiditis. The ultrasound-guided fine-needle aspiration biopsy of the lesion was consistent with a metastasis of follicular thyroid carcinoma. The sonographic neck evaluation revealed no thyroid nodules but three markedly hypoechoic and highly vascularized areas, with irregular margins and hyperechoic spots. In the clinical suspicion of primary thyroid neoplasm, ultrasound-guided fine-needle aspiration biopsy of two of the three areas was performed, but both cytological reports were non-diagnostic, revealing only colloid and blood. Subsequently, the patient underwent surgical removal of the cervical mass, with the intra-operatory consultation with frozen section examination suggesting follicular-like neoplasia. For this reason, thyroidectomy with both central and lateral neck dissection was performed. Surprisingly, the final histologic examination revealed chronic thyroiditis in the thyroid specimen and no evidence of metastasis in the left neck mass. Consequently, the pathological revision of the frozen section assessment led to the final diagnosis of chronic thyroiditis on the lateral ectopic thyroid. This case represents an uncommon example of lateral ectopic thyroid tissue with coexisting normally located thyroid tissue both affected by chronic thyroiditis. Learning points Ectopic thyroid must be considered in the diagnostic work-up of lateral neck mass. Even if rare, ectopic thyroid tissue can be found lateral to the carotid sheath and with coexisting normally located thyroid tissue. As the orthotopic tissue, lateral ectopic thyroid tissue can be affected by chronic thyroiditis, which may complicate the diagnosis both on ultrasound and cytology.

scholarly journals A Report About a 23-year-old Young Mother Suffering From Rare Insular Thyroid Carcinoma

2020 ◽  
Author(s):  
haibin chen ◽  
zhongmin liu ◽  
xiaoyan liang ◽  
rui wu
Keyword(s):  
Thyroid Carcinoma ◽  
Elderly Women ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Maximum Diameter ◽  
Young Mother ◽  
Left Neck ◽  
Poor Differentiation ◽  
Needle Aspiration Cytology ◽  
Histopathological Results

Abstract Background Insular carcinoma of thyroid (ICT) is a rare malignant tumor with poor differentiation of the thyroid , most patients are middle-aged and elderly women. Here is a report of a case involving a young woman suffering from insular thyroid carcinoma.Case report This report is about a 23-year-old young mother who already has three children of hers. she accidentally discovered a left neck mass with slight pain from local compression about half a year ago and did not seek medical treatment. She came to the hospital this time because the neck mass recently increased rapidly and she felt pressure on the trachea, affecting swallowing. Ultrasonography showed that the maximum diameter of the hypoechoic nodules was 61*46mm in the left and no lymph nodes enlargement were seen on both sides.The patient had a partial left thyroidectomy and histopathological results revealed ICT. Therefore, she completed total thyroidectomy and cervical lymph node dissection. The postoperative process was relatively smooth and the patient was successfully discharged.Conclusion：Not all patients with insular thyroid carcinoma have similar imaging findings, so Fine Needle Aspiration Cytology(FNAC)pathological diagnosis is necessary before surgery.

scholarly journals Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroki Sato ◽  
Kiyoaki Tsukahara ◽  
Ray Motohashi ◽  
Midori Wakiya ◽  
Hiromi Serizawa ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Thyroid Hemiagenesis ◽  
Poorly Differentiated ◽  
Node Metastases ◽  
Right Lobe ◽  
The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

scholarly journals A Family With a Carotid Body Paraganglioma and Thyroid Neoplasias With a New SDHAF2 Germline Variant

2019 ◽  
Vol 3 (11) ◽  
pp. 2151-2157
Author(s):  
Katherine I Wolf ◽  
Michelle F Jacobs ◽  
Rohit Mehra ◽  
Priya Begani ◽  
Matthew S Davenport ◽  
...  
Keyword(s):  
Succinate Dehydrogenase ◽  
Carotid Body ◽  
Follicular Adenoma ◽  
Needle Aspiration ◽  
Neck Mass ◽  
Whole Body ◽  
Whole Body Mri ◽  
Pathogenic Variants ◽  
Assembly Factor ◽  
Associated Tumors

Abstract At least 30% of all pheochromocytomas (PCCs)/paragangliomas (PGLs) arise in patients with a germline predisposition syndrome. Variants in succinate dehydrogenase subunits A, B, C, and D (SDHA, SDHB, SDHC, and SDHD) are the most common pathogenic germline alterations. Few pathogenic variants have been reported in succinate dehydrogenase assembly factor 2 (SDHAF2). Here, we describe a 30-year-old female patient who presented with a left-sided neck mass, which was later characterized as a carotid body PGL. Genetic testing revealed a likely pathogenic SDHAF2 variant (c.347G>A;p.W116X). Two sisters carried the same pathologic variant, and screening protocols were recommended. Whole-body MRI revealed thyroid nodules; this testing was followed by fine-needle aspiration, which confirmed papillary thyroid carcinoma in one sister and a follicular adenoma in the other. The two sisters then underwent hemithyroidectomy and total thyroidectomy, respectively. Because evidence for pathogenic variants in SDHAF2 causing predisposition to PCC/PGL is limited, we discuss the challenges in mutational variant interpretation and decision making regarding screening for associated tumors.

scholarly journals Thyroglossal Duct Cyst Papillary Carcinoma With Airway Compromise

2021 ◽  
pp. 014556132110220
Author(s):  
Po-Kai Huang ◽  
Li-Chun Hsieh ◽  
Yi-Shing Leu
Keyword(s):  
Symptom Relief ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Thyroglossal Duct Cyst ◽  
Ectopic Thyroid ◽  
Airway Compromise ◽  
Duct Cyst ◽  
Complete Excision ◽  
Thyroglossal Duct ◽  
Ectopic Thyroid Tissue

Thyroglossal duct cysts are typically benign and usually asymptomatic. Malignant transformation is uncommon. Intralaryngeal extension is rare and results in dysphonia or dyspnea. There is no literature nowadays reporting the thyroglossal duct cyst carcinoma combining the clinical features of intralaryngeal extension. The authors present a case of progressive hoarseness and midline neck mass for 2 years. The laryngoscope and computed tomography revealed a 6-cm thyroglossal duct cyst containing ectopic thyroid tissue with intralaryngeal extension and causing airway obstruction. Complete excision with Sistrunk operation revealed papillary thyroid carcinoma. The patient resumed normal phonation after the surgery. There was no evidence of tumor recurrence and no hoarseness or dyspnea at 6 months follow up. This is the first reported case of a huge thyroglossal duct cyst carcinoma with intralaryngeal extension causing airway compromise. Complete excision of tumor is essential and vital to the symptom relief. A thyroglossal duct cyst carcinoma with endolaryngeal involvement should be considered in the differential diagnosis when the case has a massive midline neck mass with ectopic thyroid tissue and develops dyspnea or hoarseness concurrently.

scholarly journals Sarcoid-like reaction associated with lung adenocarcinoma: A case report

2018 ◽  
Vol 28 (1) ◽  
pp. 68-70
Author(s):  
Qiao Li Tan ◽  
Leong Chai Leow ◽  
Salahudeen Mohamed Haja Mohideen ◽  
Duu Wen Sewa
Keyword(s):  
Lung Adenocarcinoma ◽  
Lower Lobe ◽  
Rare Condition ◽  
Disease Recurrence ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Transbronchial Needle Aspiration ◽  
Surveillance Imaging ◽  
Bilateral Hilar Lymphadenopathy ◽  
History Of

A 71-year-old woman with a history of left lower lobe lobectomy 4 years ago for adenocarcinoma of the lung presented with new mediastinal and bilateral hilar lymphadenopathy on surveillance imaging, suspicious for disease recurrence. She underwent an endobronchial ultrasound-guided transbronchial needle aspiration of the lymph nodes and histology yielded non-necrotizing epithelioid granulomas with no evidence of malignancy. A diagnosis of sarcoid-like reaction associated with lung adenocarcinoma was made. The significance of this rare condition is discussed.

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