Fortis Hospital Removes Rare large Parathyroid Cyst Affecting Nerves Controlling Vocal Cords; Saves Patient from Voice Loss
Fortis Escorts Hospital in the city has become the first in Rajasthan to successfully operate a rare case of parathyroid cyst that has only 300 instances across the world. A team of doctors, led by Dr Mohan Khulahri, ENT/ Otorhinolaryngology, Fortis Escorts Hospital, Jaipur successfully performed hemithyroidectomy (the surgery to remove part of the thyroid gland) and removed the cyst from the 53-year-old man.
The patient was brought to the hospital with pain in the throat, difficulty in swallowing and fullness in the left side of the neck. Upon performing a contrast-enhanced computed tomography (CECT) and ultrasonography (USG), a large cyst adjacent to the left lobe of the thyroid, abutting the trachea and oesophagus was diagnosed. Upon testing through fine needle aspiration cytology (FNAC), suggestive of a colloid goitre (a benign, noncancerous enlargement of thyroid tissue) was diagnosed though he had no symptoms of hyperparathyroidism, and calcium level was normal.
“Cystic disease of the parathyroid gland is quite rare as compared to adenomas (a benign tumour) and only around 300 cases of parathyroid cyst have been reported worldwide till date. This case was tricky because radiological examinations and FNAC indicated two different conditions – thyroid nodule with cystic degeneration and parathyroid cyst. We finally decided to go ahead with hemithyroidectomy (surgical removal of all or part of the thyroid gland) and the cyst. Besides, the patient has a family history of cancer and our challenge was to remove the thin wall cysts intact to prevent recurrence and for definitive diagnosis,” says Dr Kulhari, ENT/ Otorhinolaryngology, Fortis Escorts Hospital, Jaipur.
During the operation, the recurrent laryngeal nerve was found displaced laterally and posteriorly and attached to the thin cyst wall. “The recurrent laryngeal nerves lie on both sides of the windpipe in the area where the parathyroid glands are located. These nerves control the vocal cords and any injury to one of the nerves may cause hoarseness or a whispering quality to the voice. The nerve was detached very carefully from the cyst. We removed the left half of his thyroid gland and brought out the cyst intact which was detected as a large parathyroid cyst (6.5 x 5.5 x 4.5 cm) through histopathology,” says Dr Baljeet Singh Khanduja, Senior Consultant- ENT/ Otorhinolaryngology, Fortis Escorts Hospital, Jaipur.
“This has been a unique and unprecedented opportunity for Indian medical fraternity to display its dexterity in sensitive surgeries. The legacy of Fortis has been upheld by the quick and meticulous solution provided by our competent team of doctors. I would like to thank Dr Mohan Kulhari, Dr Baljeet Singh Khanduja and other supporting teams for their extraordinary support to the hospital to uplift the skills of the hospital. I am certain that with such brilliant professionals under our roof Fortis is sure to augment the path of excellence for Indian medical fraternity”, says Neerav Bansal, Zonal Director, Fortis Escorts Hospital, Jaipur, Rajasthan.
