Occult parathyroid carcinoma in a patient with papillary thyroid carcinoma and Hashimoto’s thyroiditis

Abstract

A 47-year-old female patient with a previous history of right thyroid lobectomy was admitted to the hospital because of a 3 cm nodule in the thyroid gland. Hormonal evaluation showed subclinical hypothyroidism with serum levels of thyroid stimulating hormone slightly elevated to 4.4 microg/dl (normal: 0.4-4 microg/dl). Thyroid ultrasound showed diffuse irregularity of the gland and the presence of a solitary nodule (30x18 mm in diameter) localized in the left lobe. A fine needle aspiration biopsy was performed. Cytological analysis revealed papillary thyroid carcinoma and Hashimoto's thyroiditis. Total thyroidectomy was performed. During the operation, two of the parathyroid glands were detected to be hyperplastic. Histopathological examination of the thyroid and parathyroid glands revealed Hashimoto's thyroiditis with papillary thyroid carcinoma and synchronous carcinoma of the parathyroid gland. To our knowledge, this association of occult parathyroid carcinoma in a patient with papillary thyroid carcinoma and Hashimoto's thyroiditis has not been reported in the literature. Given the high prevalence of autoimmune diseases in elderly women, a random occurrence of this triad represents the most likely explanation.

Synchronous parathyroid carcinoma and papillary thyroid carcinoma

“…Synchronous parathyroid and nonmedullary thyroid carcinomas are extremely rare with only 15 previous cases reported in literature, 1,5–7,13–23 and no correlation, up to date, has been discovered between these entities 24 . Twelve patients (84%) were females with relatively young age (mean age of 56 years).…”

An Unusual Simultaneous Existence of Parathyroid Carcinoma and Papillary Thyroid Carcinoma: Case Report and Review of Literature

“…e simultaneous presence of thyroid and parathyroid carcinoma is extremely rare with only 15 documented cases [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] in the last 41 years, and no correlation, up to date, has been discovered between these entities [31]. Comparison of the previous cases and ours are described in Table 1.…”

A Rare Co-Occurrence of Parathyroid and Papillary Thyroid Carcinoma

“…In contrast, the synchronous occurrence of parathyroid and differentiated thyroid carcinoma is a rare situation. A search of the literature found only six previous reports of synchronous parathyroid and non-medullary thyroid carcinoma [10][11][12][13][14][15]. The etiology of PC is unknown.…”