Department of Endocrinology and Metabolism, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756-0001, USA.
Endocr Pract. 2010 Jul-Aug;16(4):664-8. doi: 10.4158/EP10061.CR.
To describe a rare manifestation of parathyroid carcinoma in association with papillary thyroid carcinoma.
We describe the clinical history, findings on physical examination, results of laboratory studies, imaging findings, and histopathologic features of a woman with 2 previously palpable thyroid nodules and mild hypercalcemia.
A 79-year-old woman presented to our endocrinology clinic for reevaluation of 2 thyroid nodules and long-standing hyperparathyroidism. She initially had undergone assessment 6 years previously, at which time an intact parathyroid hormone level was 89 pg/mL (reference range, 10 to 69) and the serum calcium concentration was 10.4 mg/dL (reference range, 8.2 to 10.2) in conjunction with normal alkaline phosphatase, creatinine, and 25-hydroxyvitamin D levels. Subsequently, she was found to have multifocal papillary thyroid cancer in the right thyroid lobe and a 5-cm parathyroid carcinoma in the left side.
Synchronous parathyroid and thyroid carcinomas are extremely rare. To our knowledge, our current case is the first documented patient with parathyroid carcinoma who had a clinical presentation consistent with longstanding mild adenoma in addition to synchronous papillary thyroid carcinoma.
描述甲状旁腺癌伴甲状腺乳头状癌的罕见表现。
我们描述了一位女性的临床病史、体格检查结果、实验室研究结果、影像学表现和组织病理学特征，该女性有 2 个先前可触及的甲状腺结节和轻度高钙血症。
一名 79 岁女性因 2 个甲状腺结节和长期甲状旁腺功能亢进症到我们的内分泌科诊所就诊。她最初在 6 年前接受了评估，当时完整的甲状旁腺激素水平为 89 pg/mL（参考范围为 10 至 69），血清钙浓度为 10.4 mg/dL（参考范围为 8.2 至 10.2），同时碱性磷酸酶、肌酐和 25-羟维生素 D 水平正常。随后，她被发现右侧甲状腺叶有多发性甲状腺乳头状癌，左侧有 5cm 甲状旁腺癌。
同时发生的甲状旁腺和甲状腺癌极为罕见。据我们所知，我们目前的病例是首例记录在案的甲状旁腺癌患者，其临床表现与长期存在的轻度腺瘤一致，此外还伴有同时发生的甲状腺乳头状癌。
