Endocrine Abstracts

Introduction: Association between primary hyperparathyroidism and nodular thyroid disease is well recognized, this is mainly due to the high prevalence of this disease. However, association between thyroid carcinoma and primary hyperparathyroidism is less common.

Observation: Fifty-two years old patient with a history of renal colic and upper limb spontaneous fracture was followed for multinodular goiter evolving for 20 years. The patient had clinically diffused bone pain, fatigue and weight loss. Hypercalcemia at 132 mg/l was discovered during pre-anesthetic assessment. The assessment had objectified goiter multinodular classified TIRADS 3, high parathyroid hormone to 256 pg / ml (3 x normal), a right lobar parathyroid adenoma in supraclavicular with thyroid focal area capturing the MIBI scintigraphy. The cervical scan with additional angioscan showed a multi-hetero nodular goiter associated with a nodule above right clavicle inter-aorto-caval measuring 2 cm. The patient had undergone, after medical preparation a total thyroidectomy with resection of the ectopic parathyroid adenoma. Histopathological examination objective a papillary carcinoma with vesicular and insular differentiation and parathyroid adenoma. Evolution was favorable after surgery. The patient presented hypocalcemia needing calcium supplementation orally. Our patient received additional radioactive iodine therapy one month after surgery.

Conclusion: The observation of this case emphasizes the importance of a thorough thyroid gland and parathyroid glands evaluation in patients with primary hyperparathyroidism or thyroid disease to reveal or exclude simultaneous presence of a parathyroid adenoma and a thyroid carcinoma.