Campennì Alfredo, Giovinazzo Salvatore, Pignata Salvatore Antonio, Di Mauro Francesca, Santoro Domenico, Curtò Lorenzo, Trimarchi Francesco, Ruggeri Rosaria Maddalena, Baldari Sergio
Department of Biomedical and Dental Sciences and Morpho-functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy.
Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy.
Endocrine. 2017 Apr;56(1):19-26. doi: 10.1007/s12020-016-1147-7. Epub 2016 Oct 15.
Parathyroid carcinoma is a rare malignancy, which usually occurs as a sporadic disease, and less frequently in the setting of genetic syndromes. Despite the association of parathyroid and thyroid disorders being quite common, the coexistence of parathyroid carcinoma and thyroid disease is rare. We reviewed the pertinent literature. The terms "parathyroid carcinoma" and "thyroid disease, hyperthyroidism, thyrotoxicosis, hypothyroidism, thyroid nodule(s), Graves' disease, autonomously functioning thyroid nodules" were used both separately and in reciprocal conjunction to search MEDLINE for articles published from January 2007 to March 2016. The search was prompted by the observation of a never reported association of autonomously functioning thyroid nodules and parathyroid carcinoma. Two hundred and twenty-one parathyroid carcinoma patients have been described during the last 10 years. Neck ultrasonography and parathyroid scintigraphy are the most common instrumental studies used in detecting parathyroid lesions. Serum parathyroid hormone and calcium levels are high in the majority of parathyroid carcinoma patients. Only 21 patients with parathyroid carcinoma and thyroid disorders were found. Our patient is the first casual association between parathyroid carcinoma and autonomously functioning thyroid nodules reported in literature and diagnosed using parathyroid and thyroid scintigraphies. Parathyroid carcinoma is a very rare endocrine tumor and association with thyroid disease is not frequent. Parathyroid carcinoma pre-operative diagnosis is often difficult also because available literature data are not homogenous and there is not a common operative guideline. Our case confirms the role of parathyroid scintigraphy, encouraging the association with thyroid scintigraphy, especially in the presence of (multi)-nodular goiter in order to address the most appropriate surgical management.
甲状旁腺癌是一种罕见的恶性肿瘤，通常表现为散发性疾病，在遗传综合征背景下发病较少。尽管甲状旁腺疾病与甲状腺疾病的关联相当常见，但甲状旁腺癌与甲状腺疾病并存的情况却很罕见。我们回顾了相关文献。使用“甲状旁腺癌”和“甲状腺疾病、甲状腺功能亢进、甲状腺毒症、甲状腺功能减退、甲状腺结节、格雷夫斯病、自主功能性甲状腺结节”等术语，分别及相互结合在MEDLINE中检索2007年1月至2016年3月发表的文章。此次检索是由观察到自主功能性甲状腺结节与甲状旁腺癌之间一种从未报道过的关联而引发的。在过去10年中，共描述了221例甲状旁腺癌患者。颈部超声检查和甲状旁腺闪烁扫描是检测甲状旁腺病变最常用的影像学检查。大多数甲状旁腺癌患者的血清甲状旁腺激素和钙水平升高。仅发现21例甲状旁腺癌合并甲状腺疾病的患者。我们的患者是文献中报道的首例经甲状旁腺和甲状腺闪烁扫描诊断的甲状旁腺癌与自主功能性甲状腺结节的偶然关联。甲状旁腺癌是一种非常罕见的内分泌肿瘤，与甲状腺疾病的关联并不常见。甲状旁腺癌的术前诊断往往也很困难，因为现有文献数据并不统一，且没有通用的手术指南。我们的病例证实了甲状旁腺闪烁扫描的作用，鼓励将其与甲状腺闪烁扫描相结合，尤其是在存在（多）结节性甲状腺肿的情况下，以便采取最合适的手术治疗方案。
