Benign parathyroid cyst causing vocal fold paralysis: a case report and review of the literature

Head & Neck
Daniel H Coelho, Howard P Boey

Abstract

Parathyroid cysts are uncommon, frequently asymptomatic lesions of the neck and superior mediastinum. Symptomatic parathyroid cysts are very rare, with roughly only 200 cases reported in the literature. Of these, only nine cases have been reported with recurrent laryngeal nerve (RLN) paralysis We report a case of a 49-year-old man initially seen with a 6-month history of worsening hoarseness. Physical examination revealed a palpable 3-cm, firm, smooth, nontender mass of the right thyroid lobe. Fiberoscopic laryngoscopy showed right vocal cord immobility consistent with RLN paralysis. After CT and fine-needle aspiration of the mass, the patient underwent a right thyroid lobectomy. During surgery, the recurrent laryngeal nerve was found to be stretched and adherent to a right inferior lobe mass. Histologic analysis of the surgical specimen revealed a benign parathyroid adenomatous cyst. Postoperatively, the patient's voice improved markedly. This case represents an extremely rare return of function of the RLN after cyst removal. Parathyroid cysts should be included in the differential diagnosis for vocal fold paralysis.

References

Mar 1, 1978·American Journal of Surgery·O H Clark
Mar 1, 1984·Archives of Surgery·A D Katz, D Dunkleman
Jul 1, 1993·The Australian and New Zealand Journal of Surgery·A B GreyI M Holdaway
Jul 1, 1996·Head & Neck·A AlviP Wasserman
Apr 1, 1997·The Annals of Thoracic Surgery·O LandauS Keshavjee
Apr 5, 2000·The Journal of Laryngology and Otology·P SenA V Spedding
Sep 25, 2001·The Laryngoscope·P S IhmN J Hardin

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Citations

Sep 13, 2015·Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale·Emily Kay-RivestVéronique-Isabelle Forest
Jun 1, 2010·São Paulo Medical Journal = Revista Paulista De Medicina·Carlos Eduardo Molinari NardiRogério Aparecido Dedivitis
Jul 12, 2018·Medicine·Theodosios S PapavramidisAntonios Michalopoulos
Oct 22, 2016·Familial Cancer·Tiziana CavalliFrancesco Tonelli

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