Concurrent parathyroid carcinoma and adenoma: A rare presentation of a rarer disease entity

Sk, Chatterjee; Ray, Udipta; Gupta, Swapnil; Basu, Arghya

doi:10.4103/2230-8210.117231

Cited by 2 publications

(7 citation statements)

References 9 publications

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“…Functional PTCa occurrence is well documented, however, its sporadic synchronous occurrence in the presence of PTa in individuals with no identifiable risk factors has rarely been published. To our knowledge, only three (7,11,12) clearly documented cases have been previously reported (Table 1), with one case of nonfunctioning PTCa and PTa (13).…”

Section: Discussionmentioning

confidence: 95%

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A rare case of symptomatic hyperparathyroidism in an elderly patient with dual pathology

et al. 2018

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Primary hyperparathyroidism secondary to true sporadic synchronous parathyroid cancer (PTCa) and adenoma (PTa) is rare. This is a case of an 80-year-old female admitted with symptomatic hypercalcaemia, raised serum calcium (Ca) of 3.39 mmol/L and raised parathyroid hormone (PTH) of 44.3 pmol/L. Ultrasonic evaluation of the neck revealed a mass posterior to the right thyroid lobe. Imaging of the left neck was unremarkable. Subsequent sesta-MIBI and single-photon emission computed tomography-computed tomography (SPECT-CT) scanning highlighted conspicuous activity over the right lower neck consistent with the neck ultrasound scan findings. Pre-operatively, PTa was suspected. Intra-operatively, malignancy was suspected due to infiltration of the parathyroid tumour into the thyroid. The right inferior parathyroid and right thyroid gland were resected. Histology confirmed PTCa. Despite surgical treatment, she was found to have persistently high Ca and PTH levels. Further investigation with a repeat sesta-MIBI and SPECT-CT suggested a left inferior parathyroid tumour. Excision of this mass revealed a PTa. Recovery was unremarkable and serum biochemistry returned to normal ranges.

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Section: Discussionmentioning

confidence: 95%

“…Hence, although PTCa is an uncommon cause of primary hyperparathyroidism, it is important to suspect and exclude it. Routine bilateral neck exploration with identification of all four parathyroid glands should be performed in individuals with suspected PTCa to minimise this risk (12).…”

Section: Discussionmentioning

confidence: 99%

A rare case of symptomatic hyperparathyroidism in an elderly patient with dual pathology

et al. 2018

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“…To our knowledge, only four patients with multiglandular concurrent parathyroid adenoma and carcinoma have been reported until now [9][10][11][12]. Chatterjee et al [9] have reported a case of multiglandular parathyroid neoplasm with carcinoma on one side and adenoma on the contralateral side of the neck. Goldfarb et al [12] have reported a patient with synchronous parathyroid carcinoma, parathyroid adenoma, and papillary thyroid carcinoma.…”

Section: Discussionmentioning

confidence: 98%

“…Most of patients with parathyroid carcinoma present with a neck mass and these patients generally tended to have severe PHP [2] and absence of this findings result in significant diagnostic challenge for the clinician [9]. To our knowledge, until now only 9 PHP patients with large mediastinal ectopic parathyroid carcinoma have been reported in the literature [3][4][5][6][7][8] and four cases of concurrent parathyroid adenoma and carcinoma in the neck have been reported [9][10][11][12]. In this paper, a patient with concurrent ectopic mediastinal parathyroid carcinoma and neck parathyroid adenoma is presented.…”

Section: Discussionmentioning

confidence: 99%

“…These patients with mediastinal mass generally tended to have severe PHP [2]. Despite the common view that parathyroid carcinoma occurs in only a single parathyroid gland, very rare cases of multiglandular parathyroid carcinoma have also been observed [9]. We present a patient with concurrent ectopic left mediastinal parathyroid carcinoma and parathyroid adenoma localized on the right side of neck.…”

Section: Introductionmentioning

confidence: 90%

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Concurrent ectopic mediastinal parathyroid carcinoma and neck parathyroid adenoma: a rare presentation

Çalışkan¹,

Beysel²,

Kızılgül³

et al. 2018

Ortadogu Tıp Derg

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While mediastinal parathyroid carcinoma is a rare entity by itself, multiglandular coexistence of parathyroid carcinoma and parathyroid adenoma represents an extremely rare condition. Herein, we report such a rare presentation of multiglandular parathyroid neoplasm with an ectopic parathyroid carcinoma in the mediastinum and parathyroid adenoma on neck in a patient with persistent primary hyperparathyroidism (PHP). This 38-year-old female patient who initially presented with nephrolithiasis and osteopenia was subsequently diagnosed as having PHP. Following bilateral surgical neck exploration, existence of a parathyroid adenoma on the right side of neck was revealed. However, due to the persistence of hypercalcemia postoperatively, a single photon emission computed tomographic (SPECT/CT) examination was performed which showed a mass lesion in the anterior mediastinum. A surgical procedure was performed and the lesion, 10x10x3 mm in dimensions, confirmed to be a parathyroid carcinoma by histopathologic examination. At 1-year of follow-up there was no tumor recurrence or hypercalcemia. This is the first patient who had coexistent of ectopic mediastinal parathyroid carcinoma and parathyroid adenoma in the neck with persistent PHP. This case emphasises the difficulties in diagnosing and managing parathyroid disease. Multiple diagnostic studies are crucial for identification of multiple parathyroid glands in patients with persistent PHP.

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Concurrent parathyroid carcinoma and adenoma: A rare presentation of a rarer disease entity

Cited by 2 publications

References 9 publications

A rare case of symptomatic hyperparathyroidism in an elderly patient with dual pathology

A rare case of symptomatic hyperparathyroidism in an elderly patient with dual pathology

Concurrent ectopic mediastinal parathyroid carcinoma and neck parathyroid adenoma: a rare presentation

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