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Giant Cystic Parathyroid Adenoma Masquerading as a Retropharyngeal Abscess

Diom ES *,Fagan JJ ,Dhirendra Govender

Objective: A case report of a retropharyngeal cystic parathyroid adenoma and a review of its embryology, differential diagnosis and management are presented.

Material and Method: A 34-year-old woman presented with a 2-year history of a right-sided discrete, cystic, submucosal cervical mass displacing the oropharynx anteriorly. MRI showed a large, cystic hyperdense mass occupying the parapharyngeal and retropharyngeal spaces. Surgical resection revealed a right-sided multinodular neck mass originating from the thyroid gland and extending along the prevertebral space and towards the contralateral neck, displacing the pharynx and larynx. Histology was consistent with a cystic parathyroidadenoma.

Discussion: Cystic parathyroid adenoma has rarely been reported and may mimic a retropharyngeal abscess. The unusual location of parathyroid tissue can be explained by its origin from ectopic superior parathyroid glands or tumor extension from parathyroid glands intothe retropharyngeal space.

Conclusion:The differential diagnosis of a retropharyngeal mass should include parathyroid tumours.