IntroductionPrimer hyperparathyroidism is the most common cause of hypercalcemia in patients who referred to the policlinics [1]. Thyroid Cancer (ca) is observed nearly %1 in all cancers. It has been increasing most common type and consisting about 80% of the thyroid cancers. Papillary and follicular cancer's incidence increases with age median age is 45-50 years [2]. Coexistence of nonmeduller thyroid ca and primer hyperparathyroidism is very rare situation. Coincidence of nonmeduller thyroid ca and primer hyperparathyroidism is reported as %2-13 [3].We present here a 29-year-old woman who had papillary thyroid carcinoma and parathyroid carcinoma concurrent.
Case presentationA 29 year old woman with a 2-month history of loss of appetite, weight loss, fatigue, tiring easily that affect her daily work, 5 days history of nausea and vomiting presented to our internal medicine clinic in October 2015. She was treating for urolithiazis for four years and referred to the emergency clinic for nausea and vomiting yesterday. She has no other familial disorders. Physical examination was normal. Her biochemical parameters revealed very high Calcium (Ca) levels. Her Ca is found 14.50 mg/dl (8,6-10 mg/dl), Parathyroid Hormone (PTH) level is found 851.5 pg/ml ( 11,1-79,5 pg/ml), 25-Hidroksi Vitamin D: 20 ng/ml. To investigate Primer hyperparathyroidism thyroid usg ve and Tc-99m MIBI parathyroid scintigrafia was performed.In Thyroid usg: Right lobe of the thyroid anterior posterior diameter is 23 millimeters (mm) measured. It was increased. Left lobe of the thyroid Antero Posterior diameter (AP) is 15 mm, isthmus AP diameter is 2mm measured. It was in physiological levels. In right lobe anterior segment 16x10mm, properly limited, including internal punctuate calcifications hypo echoic, hyper vascular nodule was observed. Also there is a 21x28 mm lobulated, containing internal echogenic septation solid nodules starting from central part of the right lobe ongoing up to posterior were observed. In both lobes colloidal cystic nodules were observed in mill metric scale.In thyroid gland left lobule early images revealed that activity distribution is homogeneous and in normal range. The upper lobe of right middle lobe's activity uptake was increased. In late images when washout was defined from left lobe and lower pole of right lobe in the right lobe uptake persevered. It evaluated atopic for parathyroid adenoma by reason of settlement by scintigraphy. It was also reported to be secondary to thyroid pathology.The patient was hydrated. Ca level was found 12.40 mg/dl and 13.20 mg/dl. Despite hydration her Ca level did not fall more. She was Demir D, et al., J Diabetes Metab Disord 2017, 4: 020 DOI: 10.24966/DMD-201X/100020