Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2017
The dangers of parathyroid biopsy.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Kim Joanne, Horowitz Gilad, Hong Michael, Orsini Mario, Asa Sylvia L, Higgins Kevin
Аннотация
BACKGROUND: We report an unusual case of a 66-year-old female with a suspicious thoracic outlet mass presenting with severe biochemical hyperparathyroidism and classic hypercalcemic symptoms of renal and bone involvement.
CASE PRESENTATION: There was clinical suspicion for parathyroid carcinoma, further supported by intra-operative findings. However, the final pathology described a primary hyperceullar parathyroid lesion with pathognomonic changes secondary to fine-needle aspiration (FNA) biopsy, along with a separate parathyroid lesion likely resulting from seeding along the needle tract. Upon further review, record of a remote FNA was discovered. This case highlights the complications associated with parathyroid FNA resulting in a diagnostic challenge and raising the possibility of malignancy.
CONCLUSIONS: We therefore recommend to take caution when there is a prior parathyroid FNA, as it can present with the risks of a secondary lesion from seeding and increase resemblance of malignancy both clinically and through pathologic diagnosis.
CASE PRESENTATION: There was clinical suspicion for parathyroid carcinoma, further supported by intra-operative findings. However, the final pathology described a primary hyperceullar parathyroid lesion with pathognomonic changes secondary to fine-needle aspiration (FNA) biopsy, along with a separate parathyroid lesion likely resulting from seeding along the needle tract. Upon further review, record of a remote FNA was discovered. This case highlights the complications associated with parathyroid FNA resulting in a diagnostic challenge and raising the possibility of malignancy.
CONCLUSIONS: We therefore recommend to take caution when there is a prior parathyroid FNA, as it can present with the risks of a secondary lesion from seeding and increase resemblance of malignancy both clinically and through pathologic diagnosis.