A Functional Parathyroid Cyst from the Hemorrhagic Degeneration of a Parathyroid Adenoma

Atsuko Uehara; Tomo Suzuki; Yutaro Yamamoto; Masataka Hasegawa; Kenichiro Koitabashi; Masahiko Yazawa; Junki Koike; Yugo Shibagaki

doi:10.2169/internalmedicine.3319-19

CASE REPORTS

A Functional Parathyroid Cyst from the Hemorrhagic Degeneration of a Parathyroid Adenoma

Atsuko Uehara, Tomo Suzuki, Yutaro Yamamoto, Masataka Hasegawa, Kenichiro Koitabashi, Masahiko Yazawa, Junki Koike, Yugo Shibagaki

Author information

Atsuko Uehara
Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
Tomo Suzuki
Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
Department of Nephrology, Kameda Medical Center, Japan
Yutaro Yamamoto
Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
Masataka Hasegawa
Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
Kenichiro Koitabashi
Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
Masahiko Yazawa
Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
Junki Koike
Department of Pathology, St. Marianna University School of Medicine, Japan
Yugo Shibagaki
Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan

Keywords: hypercalcemia, primary hyperparathyroidism, acute kidney injury, functional parathyroid cyst

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 3 Pages 389-394

DOI https://doi.org/10.2169/internalmedicine.3319-19

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Abstract

A 77-year-old man with a history of hypertension, prostate hyperplasia, and urolithiasis was admitted for acute kidney injury caused by hypercalcemia. Neck ultrasonography showed a large cyst adjacent to the right lower thyroid lobe. Although a ^99mtechnetium sestamibi scan was negative, an extremely high intracystic intact parathyroid hormone level suggested that the cyst had a parathyroid origin and that a functional parathyroid cyst was present. Immunohistochemical staining for the calcium-sensing receptor (CaSR) after right lower parathyroidectomy revealed CaSR-positive cells lining the cyst, indicating that the functional parathyroid cyst had originated from the hemorrhagic degeneration of a parathyroid adenoma.

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