Intrathyroidal parathyroid carcinoma: a case report

Trabelsi Wejdan Mohamed; Mohamed Dhaha; Fatma Haffeni; Rim Baraham; Alia Methnani; Souheil Jbali; Sawsen Dhambri; Skander Kedous

doi:10.1530/endoabs.101.PS1-03-09

PS1-03-09

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Endocrine Abstracts (2024) 101 PS1-03-09 | DOI: 10.1530/endoabs.101.PS1-03-09

ETA2024 Poster Presentations Thyoid cancer case reports-1 (9 abstracts)

Intrathyroidal parathyroid carcinoma: a case report

Wejdan Mohamed Trabelsi ¹ , Mohamed Dhaha ² , Fatma Haffeni ² , Rim Baraham ² , Alia Methnani ³ , Souheil Jbali ⁴ , Sawsen Dhambri ² & Skander Kedous ⁵

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¹Salah Azaiez Institut, Ent, Tunis, Tunisia; ²Salah Azaeiz Institute, Ent, Ent, Tunis, Tunisia; ³Salah Azaiez Institute, Ent, Ent, Tunis, Tunisia; ⁴Salah Aziez Institute, Ent, Ent, Tunis, Tunisia; ⁵Salah Azaeiz Institue, Ent, Ent, Tunis, Tunisia

Introduction: Parathyroid carcinoma (PTC) is a very rare neuroendocrine malignancy. It accounts for approximately 1% of primary hyperparathyroidism. Intrathyroidal localization is extremely rare.

Aim : On the basis of a case report and literature data, we describe the particularities of this rare pathological entity.

Observation: 53-year-old female patient with history of recent venous thrombosis referred for management of a left thyroid nodule discovered by chance during a CT scan ordered to investigate severe anemia associated with secondary osteolytic bone lesions. Clinical examination revealed a 1 cm right paramedian basi-cervical swelling and an anodular left lobe. Cervical ultrasound showed a left thyroid nodule. Preoperative workup revealed normal calcium and phosphorus levels and a normal renal workup. The patient underwent left loboisthmectomy with extemporaneous examination showing atypical cells with vesicular neoplasms. The parathyroid glands were not visualized on the left side, and totalization was performed due to the patient’s anaesthetic difficulties. The definitive anatomopathological examination with immunohistochemical study concluded to a parathyroid carcinoma of intrathyroidal localization. Postoperatively, the patient developed hypocalcemia requiring parenteral calcium supplementation with normal PTH value.

Conclusion: PTC is a very rare malignancy. Intrathyroidal localization is exceptional and presents a diagnostic challenge in the absence of clinical and morphological specificities.