Synchronous Parathyroid Carcinoma and Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features

Abstract

Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. Compared to parathyroid adenoma, parathyroid cancer is more likely to be associated with marked levels of serum parathyroid hormone (PTH) and hypercalcemia with severe clinical manifestations. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a rare variant of papillary thyroid cancer. Here, we report the case of a middle-aged woman who presented with multiple fractures and neck swelling. Neck ultrasound and fine-needle aspiration cytology revealed a provisional diagnosis of thyroid carcinoma. Parathyroid and bone scan were performed because of primary hyperparathyroidism and hypercalcemia and established the diagnosis of hyperfunctioning right-sided parathyroid tumor. Right parathyroidectomy and total thyroidectomy were performed, and the histopathological report confirmed the diagnosis of parathyroid carcinoma and NIFTP. The synchronic coexistence between parathyroid cancer and thyroid neoplasms is an extremely rare condition that prompted us to report this case.

Coexistence of parathyroid adenoma, autonomous functioning thyroid nodule, and papillary thyroid carcinoma: a case description

“…Thyroid disorders occur in about 15-75% of patients with parathyroid diseases (2,3). While hyperparathyroidism (HPT) and concomitant medullary thyroid cancer (MTC) are well described in multiple endocrine neoplasia type 2A (MEN2A) syndrome, no obvious genetic link between PTC and HPT has been demonstrated yet (1).…”

“…However, patients with coexisting parathyroid adenoma, AFTN, and PTC are extremely rare (1). Due to the anatomically close relationship of the thyroid and parathyroid, imaging manifestations of lesions in the thyroid and parathyroid are identical or similar, which increases the difficulty of diagnosis and the likelihood of misdiagnosis and missed diagnosis (2). This report describes the case of a 53-yearold woman with a 20-year history of thyroid nodules and was preoperatively diagnosed with concomitant AFTN and parathyroid adenoma.…”