An unusual presentation of papillary thyroid carcinoma: a case report
Keywords:
Primary hyperparathyroidism, parathyroid carcinoma, differentiated thyroid carcinoma, multiple endocrine neoplasiaAbstract
Parathyroid carcinoma (PC) is exceptional cause of primary hyperparathyroidism (PHPT). It has an estimated prevalence of 0.3 to 5.6%
and is rarely associated with non-medullary thyroid cancer. We report a case of parathyroid carcinoma resulting in a hyperparathyroidism
and revealing a papillary thyroid carcinoma, and emphasize on the management particularities of this entity.
A 37-year-old woman, with prolactin secreting pituitary microadenoma, presented with asthenia and bone pain. Laboratory findings were
consistent with PHPT. Neck ultrasonography showed a 3 cm nodule adjacent to the right thyroid lobe with no abnormalities in the thyroid
gland. Parathyroid scintigraphy showed a right inferior parathyroid adenoma. Because of the patient age and the decreased renal function,
surgical treatment was required. During the intra-operative neck exploration, a juxta-thyroid tumoral right mass was strongly adherent to
the right infra-hyoid muscle and the recurrent laryngeal nerve. The frozen examination of the mass demonstrated malignancy features
suggesting a poorly differentiated thyroid carcinoma. Thus, a total thyroidectomy with bilateral central neck dissection was carried out.
Final histopathological examination showed a 3.5 cm PC infiltrating the thyroid gland with a papillary thyroid microcarcinoma of the left
thyroid lobe. External radiotherapy of the neck, indicated for PC, was performed 1 month after surgery. A radioactive iodine therapy was
used 6 months postoperatively.
Despite its rarity, PC is to bear in mind in case of PHPT. The association between PC and differentiated thyroid carcinoma is not to be
ignored.
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References
Rodrigo JP, Hernandez-Prera JC, Randolph GW, Zafereo ME, Hartl DM, Silver CE, et al. Parathyroid cancer: An update. Cancer Treat Rev. 2020;86:102012.
Kuzu F, Cinkaya A, Ekici MF, Kodaz H, Deger A. Synchronous Parathyroid Carcinoma and Multifocal Papillary Thyroid Carcinoma : A Case Report. Eurasian J Med Oncol. 2017;1(1): 49-52.
Gatta G, Capocaccia R, Botta L, Mallone S, Angelis R De, Ardanaz E, et al. Articles Burden and centralised treatment in Europe of rare tumours : results of RARECAREnet — a population-based study. The Lancet Oncology. 2017;18(8):1022-1039.
Shane E. Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab. 2001;86(2):485-93.
Kane BS, Sow M, Diagne N, Badji N, Seck M, Akpo G, et al. The Parathyroid carcinoma: a diagnostic challenge before surgery. Tunis Med. 2019;97(2):383-387.
Schulte KM, Talat N, Galata G, Gilbert J, Miell J. Oncologic Resection Achieving R0 Margins Improves Disease-Free Survival in Parathyroid Cancer. Ann Surg Oncol. 2014;21(6):1891-1897.
Edafe O, Debono M, Tahir F, Balasubramanian SP. Simultaneous presentation of parathyroid carcinoma, papillary thyroid cancer and ACTH-independent hypercortisolism due to benign cortical adenoma. BMJ Case Rep. 2019;12(9):12-5.
Morita SY, Somervell H, Umbricht CB, Dackiw APB, Zeiger MA. Evaluation for concomitant thyroid nodules and primary hyperparathyroidism in patients undergoing parathyroidectomy or thyroidectomy. Surgery. 2008;144(6):862-7.
Cinamon U, Levy D, Marom T. Is primary hyperparathyroidism a risk factor for papillary thyroid cancer? An exemplar study and literature review. Int Arch Otorhinolaryngol. 2013;19(1):42-5.
Alrezk R, Hannah-Shmouni F. MEN4 and CDKN1B mutations : The latest of the MEN syndromes. Endocr Relat Cancer. 2017;24(10):T195-T208.
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