[Primary hyperparathyroidism and papillary thyroid gland carcinoma].

The case is reported of a 70-year-old female patient with primary hyperparathyroidism and papillary thyroid carcinoma. At the age of 66, the patient had symptoms of hyperparathyroidism and underwent surgery. The operation revealed no adenoma of the parathyroids; instead, by coincidence, a papillary thyroid carcinoma was discovered. The patient was operated on again 2 years later, and only then was a principal cell adenoma of the parathyroids found and removed. Bone biopsies performed at the same time revealed distinct signs of fibroosteoclasia as well as signs of osteomalacia, probably consequent on a former operation of the stomach. Four years after the first symptoms of hyperparathyroidism the patient died of encephalorrhagia due to a brain metastasis of the papillary thyroid carcinoma. Combinations of hyperparathyroidism with thyroid cancers are relatively frequent. In most of these cases the thyroid carcinoma is a medullary (calcitonin producing) carcinoma, whereas papillary carcinomas are rather unusual. It nevertheless seems to be a typical combination, although its pathogenesis is not yet clear.