Endocrine Abstracts

Introduction: Primary hyperparathyroidism represents a commonly encountered endocrine disorder characterized by the dysregulated secretion of parathyroid hormone (PTH), often associated with a parathyroid adenoma. The simultaneous occurrence of primary hyperparathyroidism with non-medullary thyroid carcinoma is infrequent. Our cases bring attention to this atypical connection, emphasizing the unique nature of this rare association.

Cases: In Case 1, a 63-year-old female patient, presenting a history of recurrent bilateral renal lithiasis, was admitted for the management of primary hyperparathyroidism. The localization workup favored a left inferior parathyroid nodule associated with a multiheteronodular goiter classified as Eutirads 5. Subsequent intervention included left lower parathyroidectomy combined with total thyroidectomy. Anatomopathological examination revealed a parathyroid adenoma and identified a thyroid papillary microcarcinoma measuring 0.6 x 0.7 mm Case 2 involves a 66-year-old female patient with chronic renal failure at the dialysis stage, concurrently treated for primary hyperparathyroidism. The localization workup revealed a right parathyroid nodule alongside suspicious multiheteronodular nodules classified as Eutirads 4. The patient underwent total thyroidectomy associated with right parathyroidectomy. Anatomopathological study confirmed a parathyroid adenoma and disclosed a thyroid papillary carcinoma classified as PT1bNxMx.

Discussion & Conclusion: The co-occurrence of non-medullary thyroid carcinoma and hyperparathyroidism is considered rare, and the underlying mechanisms of this association remain inadequately understood. A potential hypothesis suggests a connection rooted in embryological origins and shared genetic factors, possibly exacerbated by elevated parathyroid hormone levels, diminished vitamin D levels, and hypercalcemia, resulting in heightened levels of angiogenic growth factors. While this association is infrequent, it should not be disregarded during the preoperative phase. A thorough acknowledgment of this dual pathology is crucial for ensuring optimal management of both conditions