Endocrine Abstracts

Introduction: Primary hyperparathyroidism is a frequent pathology. Its association with non-medullary thyroid carcinoma is rare (2.3–4.3%). The aim of this work is to describe the particularities of this association based on an observation.

Observation: This is a 67-year-old patient who was admitted to the department for exploration of primary hyperparathyroidism discovered during a pathological fracture. Biologically she hada calcemia at 130 mg/l a parathyroid hormone at 1541 pg/l. In the morphological assessment the cervical ultrasound had objectified Presence at the level of the lower edge of the right thyroid lobe and in the extra thyroid of two nodular formations measuring respectively 12.2x11.7x11.3 mm and 18.6x 12.2x 11.5 mm suggesting two parathyroid adenomas, associated with a multi-nodular goiter whose most pejorative nodules are lower left lobe measuring 18.3x 14.5x10 mm classified EUTIRADS 4, upper right lobe measuring 9x8.5x7.1 mm, classified EUTIRAD5. A total thyroidectomy and an adenectomy were performed, with an anatomopathological examination showing the presence of a parathyroid adenoma and a papillary carcinoma of the thyroid classified as pT3b, N1a, Mx. The patient was therefore sent to the nuclear medicine department for additional treatment with radioactive iodine.

Conclusion: The association of papillary thyroid carcinoma and primary hyperparathyroidism has been reported in 2.3–4.3% of patients operated on for primary hyperparathyroidism. Our case showed underlined the interest of concomitant management of parathyroid adenomas and thyroid nodules suspicious on preoperative imaging in order to avoid surgical revision.