Synchronous Parathyroid Carcinoma,Parathyroid Adenoma,and Papillary Thyroid Carcinoma in a Patient with Severe and Long-Standing Hyperparathyroidism |
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Affiliation: | 1. Departments of Surgery, Boston, Massachusetts.;2. Departments of Medicine, Boston, Massachusetts.;3. Departments of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.;1. Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico S. Matteo, Pavia, Pavia, Italy;2. Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy;3. Molecular Medicine Laboratory, University of Pavia, Pavia, Italy;4. Unit of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy;5. Biometric Unit, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy;6. PhD School in Experimental Medicine, University of Pavia, Pavia, Italy;1. Gubra, Hørsholm, Denmark;2. Department of Human Nutrition, University of Copenhagen, Frederiksberg, Denmark;3. Department of Biomedical Sciences, School of Veterinary Medicine, Cornell University, Ithaca, NY, USA;4. Department of Molecular Biosciences, University of California, Davis, CA, USA;1. Salzkammergutklinikum Gmunden, Department of Geriatric Acute Care, Miller von Aichholzstraße 49, 4810 Gmunden, Austria;2. Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Medical University of Vienna, Austria;3. Clinical Department For Farm Animals and Herd Management, University of Veterinary Medicine, Vienna, Austria;4. Medical University of Vienna, Center for Pathophysiology, Infectiology and Immunology, Department of Pathophysiology and Allergy Research, Spitalsgasse 23, 1090 Vienna, Austria |
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Abstract: | ObjectiveTo describe a patient presenting with the rare constellation of synchronous parathyroid carcinoma, parathyroid adenoma, and papillary thyroid carcinoma.MethodsWe summarize the clinical presentation, diagnostic work-up, surgical management, and pathologic features of our patient and review the pertinent literature.ResultsThe patient was a 59-year-old man who presented with severe clinical manifestations of long-standing primary hyperparathyroidism, a serum calcium concentration of 14.4 mg/dL, and a parathyroid hormone level of 2,023 pg/mL. He was found to have a 3.4-cm parathyroid carcinoma on the left side and a 3.2-cm papillary carcinoma in the right thyroid lobe. In addition, a 917-mg parathyroid adenoma was found on the right side.ConclusionSynchronous parathyroid and thyroid carcinomas are extremely rare. To our knowledge, our patient is the first documented case with a parathyroid adenoma in addition to synchronous parathyroid and thyroid carcinomas. The presence of concurrent parathyroid carcinoma and parathyroid adenoma can cause diagnostic confusion and should be considered in patients presenting with severe hyperparathyroidism. Any concomitant thyroid nodules must be investigated to rule out thyroid carcinoma. (Endocr Pract. 2009;15:463-468) |
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