Coexistence of parathyroid adenoma and papillary thyroid carcinoma

Abstract

PurposeAlthough several reports have been published regarding the coexistence of hyperparathyroidism and papillary thyroid carcinomas, concurrence of parathyroid adenoma and papillary thyroid carcinoma is extremely rare. The aim of this study was to describe experiences with concurrent parathyroid adenoma and papillary thyroid carcinoma.MethodsSeven patients with concurrent parathyroid adenoma and papillary thyroid carcinoma were identified between January 2006 and December 2007, and their medical records were reviewed retrospectively.ResultsOf the seven patients identified, three were male and four were female; their mean age was 53.6 years. None of the patients presented with symptomatic hyperparathyroidism preoperatively. On laboratory findings, four patients had mild to moderate hypercalcemia, but serum parathyroid hormone concentrations were high in all patients. Preoperative imaging showed suspicious features of diseased parathyroid glands in four patients; two upon ultrasonography and computed tomography together and two upon ultrasonography only. The coexistence of parathyroid adenoma did not affect the extent of thyroid surgery. Laboratory values after surgery returned to within normal ranges in all patients.ConclusionIt is important not only to analyze serum calcium levels but also to carefully interpret imaging studies in order to identify asymptomatic hyperparathyroidism when performing thyroid cancer surgery.

Concomitant Bilateral Papillary Thyroid Carcinoma and Parathyroid Adenoma

“…Lee et al's report showed that primary hyperparathyroidism was diagnosed before thyroid carcinoma based on histopathology findings [13]. Therefore, our case was confirmed by histopathology after para-thyroidectomy.…”

The coexistence of primary hyperparathyroidism and thyroid nodules: should the preoperative work-up of the parathyroid and the thyroid diseases be specifically adjusted?

“…One of the pathogenic factors invoked is the exposition to ionizing radiations: in irradiated patients, if a PHPT was present, a coexisting thyroid nodule was found in 95% of cases with a high incidence of thyroid carcinoma (30). In non-irradiated patients, both PTH and high serum calcium levels have been implicated in the pathogenesis of the non-medullary thyroid carcinoma (31)(32)(33). Anyway, this cancer should be carefully investigated because of its high frequency (29,30).…”

“…Moreover, it should be considered that PHPT can coexist with thyroid carcinoma, especially the papillary form (PTC) (22)(23)(24). All considered, the presence of both pathologies simultaneously can lead to leave the hypercalcemia, a thyroid cancer or a toxic goiter untreated and can result in a reoperative approach (5).…”

Incidental finding of papillary thyroid carcinoma with BRAFV600Emutation in a patient with coexistent primary hyperparathyroidism and Graves’ hyperthyroidism

“…Some authors assumed the oncogenic effect of hypercalcaemia on the thyroid gland may be associated 15. In a recent retrospective study, Lee et al 5 summarised the concurrence of parathyroid adenoma and PTC on seven patients. Among them, no patient had the history of head or neck irradiation or surgeries.…”