ECE2015 Eposter Presentations Clinical Cases–Thyroid/Other (101 abstracts)
A rare association: primary hyperparathyroidism and thyroid papillary carcinoma: case report
George-Sebastian Zmău 1 , Cristina Preda 1 , Cipriana Stefanescu 2 , Radu Danila 3 , Delia Ciobanu 4 , Iulia Crumpei 1 , Alina Daniela Belceanu 1 , Adina Manolachie 1 & Carmen Vulpoi 1
1Department of Endocrinology, UMF ‘Gr. T. Popa’ Iasi, Iasi, Romania; 2Department of Nuclear Medicine, UMF ‘Gr. T. Popa’ Iasi, Iasi, Romania; 3Department of General Surgery, UMF ‘Gr. T. Popa’ Iasi, Iasi, Romania; 4Department of Morphopathology, UMF ‘Gr. T. Popa’ Iasi, Iasi, Romania.
Introduction: Although, the relationship between pathological process of the parathyroid and thyroid is common, concurrence of primary hyperparathyroidism (pHPT) and papillary thyroid carcinoma (PTC) is extremely rare, probably because, unlike with medullary thyroid cancer, they have not a common embryologic origin. We present a case with this uncommon association.
Case report: A 67-year-old woman with multinodular goitre was addressed in endocrinology for persistent hypercalcaemia 11.24 mg/dl and hypophosphatemia 2.4 mg/dl. High PTH value (119 pg/ml (normal range 10–69 pg/ml) confirmed primary hyperparathyroidism. The neck ultrasound revealed a potential 0.4 ml parathyroid adenoma at the superior pole of the right thyroid lobe and a 6 ml nodular conglomerate with central necrosis in the left thyroid lobe. The 99mTc-sestamibi parathyroid scintigraphy revealed an area with increased uptake in the projection aria of the nodule described at ultrasonography. Owing to the nodular aspect of the contralateral lobe total thyroidectomy was performed and the histological examination diagnosed right superior parathyroid adenomatous hyperplasia and multicenter invasive papillary carcinoma in the left thyroid lobe with (pT3Nx-G1). Hyperparathyroidism was cured, with normal PTH and phosphocalcic parameters. For the invasice PTC radioiodine therapy was performed with complete remission from – cifra! – ani. She is no more on suppressive L-T4, having low normal TSH and absent thyroglobulin.
Conclusion: Our case illustrates an extremely rare synchronous association of primary hyperparathyroidismn with thyroid carcinomas (with an incidence roughly estimated at 0.0023/100 000 person-years). In spite of its rarity, this coexistence of pHPT and PTC maybe not a random but a possible new pathology. The concurrence of both pathological processes can make the patient management complicated, because unrecognised thyroid cancer diagnosed at the histological examination implies surgical re-intervention.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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