Unusually close association of ectopic intrathyroidal parathyroid gland and papillary microcarcinoma of the thyroid

Hw, Bernd; Hp, Horny

doi:10.1111/j.1365-2559.2004.01777.x

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Kim et al [11] reported a patient with a history of PTC in the right thyroid lobe, but the patient also had an unusual association of ETPG and ectopic intrathyroidal thymus tissue in the left thyroid lobe. Bernd et al [12] reported a concurrence of ETPG and papillary micro-carcinoma, and Abdou et al [13] reported a close association of ETPG and thyroid amyloidosis tissue inside a thyroid lobe. In our case, we introduce some guidelines on management of normal ETPG during thyroidectomy.…”

Section: Discussionmentioning

confidence: 99%

Rare concurrence of ectopic intrathyroidal parathyroid gland and papillary thyroid carcinoma within a thyroid lobe

2019

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Rationale: The inferior parathyroid glands derive from the third branchial pouch and seldom ectopically migrate to thyroid grand, mediastinum, thymus. Ectopic intrathyroidal parathyroid grand (ETPG) is rare and it cannot be consistently detected by any imaging examinations. The unusual ETPG is easily resected during thyroidectomy, which might cause postoperative hypoparathyroidism. Auto-transplantation of even a parathyroid gland can restore parathyroid function to some extent. Until now, there are not any guidelines on the management of ETPG. Patient concerns: Without any symptoms, a 27-year-old female patient was admitted to our hospital for a thyroid nodule. Thyroid ultrasonography demonstrated a hypoechoic nodule, measuring 0.6 cm × 0.6 cm × 0.7 cm, with multiple punctate micro-calcifications within the right thyroid lobe. Thyroid function tests were normal. The invasive fine needle aspiration cytology for the thyroid nodule was rejected by patient. Diagnoses: The patient was firstly diagnosed as right thyroid hypoechoic nodule, which was pathologically proved to be papillary thyroid carcinoma (PTC) finally. Interventions: The patient underwent right thyroidectomy, central compartment neck dissection, parathyroid exploration, and auto-transplantation of the normal ETPG. Outcomes: The right thyroid hypoechoic nodule was diagnosed as PTC by pathological examination. The inferior parathyroid gland could not found in normal locations. On the cut surface of excised thyroid lobe, a yellow and soft nodule was discovered and it was pathologically diagnosed as a normal parathyroid grand. In the end, auto-transplantation of the normal ETPG was conducted. Postoperative follow-ups found both serum calcium and parathyroid hormone tests were normal. Lessons: ETPG in a patient with PTC is easily overlooked and unexpectedly excised for its rarity. ETPG brings about a failed parathyroid exploration. However, within the thyroid parenchyma, it might be occasionally discovered by cutting a thyroid lobe into slices. Auto-transplantation of normal ETPG is necessary.

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Section: Discussionmentioning

confidence: 99%

Rare concurrence of ectopic intrathyroidal parathyroid gland and papillary thyroid carcinoma within a thyroid lobe

2019

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“…Such as parathyroid, thymus and lymph nodes [7] . Even though parathyroid adenomas or carcinomas inside the thyroid is far from uncommon [8] , [9] , the incidence of normal parathyroid gland embedded in the thyroid parenchyma is much scarcer with only a handful of cases [10] , [11] . Usually, in both of normal and tumorous ITP cases a solitary parathyroid nodule is imbedded inside the thyroid tissue, and so far, only 2 cases in the English literature have reported in which bilateral presence of parathyroid nodules on both sides of the thyroid gland was observed [4] , [12] .…”

Section: Discussionmentioning

confidence: 99%

Co-occurrence of bilateral intrathyroidal parathyroid gland and papillary thyroid carcinoma; a case report

Abdullah

Baba

Salih

et al. 2021

International Journal of Surgery Case Reports

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Introduction Intrathyroidal parathyroid is a parathyroid completely embedded within the thyroid parenchyma. The aim of this study is to present a case with co-occurring bilateral normal intrathyroidal parathyroid glands and papillary thyroid carcinoma (PTC). Case presentation A 35-year-old female presented with anterior neck swelling for a duration of a week. The patient was generally asymptomatic. Ultrasound showed mild enlargement of the thyroid gland, and a well-defined solid nodule measuring 9 ∗ 8 ∗ 7 mm in the left lobe with malignant characteristics. Laboratory findings were within normal limits. Fine needle aspiration of the nodule resulted in the diagnosis of PTC. The patient underwent total thyroidectomy. Histological examination confirmed the diagnosis of well differentiated multifocal bilateral PTC alongside two bilaterally located intrathyroidal parathyroid glands. Discussion The occurrence of normal ITP is exceedingly rare, and even rarer when simultaneous with other thyroidal lesions. It is theorized that inferior parathyroid glands arise from the third pharyngeal pouch, and during embryogenesis they might migrate to other anatomic locations. In this case, two bilateral normal ITP were present with PTC. Conclusion Normal ITP presents a diagnostic challenge due to their high insensitivity to current preoperative diagnostic techniques; hence, surgeons are required to carefully examine thyroid tissue during thyroidectomy when missing parathyroid glands are observed.

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Oral kavitede kitle ve eşlik eden insidental papiller tiroid karsinomu ile başvuran normokalsemik primer hiperparatiroidizm olgusu

TOPUZ

Tüzün

ÖZBAY

et al. 2022

Cukurova Medical Journal

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Hyperparathyroidism (HPT) is an endocrine disorder characterized by high secretion of parathyroid hormone. Brown tumor is one of the skeletal manifestations of HPT. Its overall prevalence is low (about 0.1%). Involvement of facial bones is extremely rare. The mandible is involved in 4.5% of cases. Primary HPT (PHPT)with vitamin D deficiency worsens the clinical course. Parathyroid adenoma is detected in ectopic places with a rate of 8.5%. 0.2% is intrathyroidal, 2% is located in different neck regions, 4.1% is in the upper mediastinum, and 2.2% is in the lower mediastinum. The prevalence of papillary thyroid cancer (PTC) in PHPT patients has been reported to range from 2% to 15%. In the literature, incidentally detected papillary thyroid cancer in patients with hyperparathyroidism was detected in patients who underwent total thyroidectomy associated with intrathyroidal parathyroid adenoma. In this article, we present a case of incidental papillary thyroid carcinoma with ectopic parathyroid adenoma accompanied by severe vitamin D, and diagnosed during accompanying surgery following a brown tumor was considered after primary hyperparathyroidism was detected. However, the patient was admitted with a mass in the oral cavity, diagnosed before as a pyogenic granuloma with a delayed diagnosis without considering brown tumor because it was normocalcemic. It is the first case in the literature of papillary thyroid carcinoma detected incidentally with ectopic parathyroid adenoma in the thyrothymic region.

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Unusually close association of ectopic intrathyroidal parathyroid gland and papillary microcarcinoma of the thyroid

Cited by 4 publications

References 7 publications

Rare concurrence of ectopic intrathyroidal parathyroid gland and papillary thyroid carcinoma within a thyroid lobe

Rare concurrence of ectopic intrathyroidal parathyroid gland and papillary thyroid carcinoma within a thyroid lobe

Co-occurrence of bilateral intrathyroidal parathyroid gland and papillary thyroid carcinoma; a case report

Oral kavitede kitle ve eşlik eden insidental papiller tiroid karsinomu ile başvuran normokalsemik primer hiperparatiroidizm olgusu

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