[Tertiary hyperparathyroidism accompanied with thyroid carcinoma and cervical lymph node sarcoidosis: a case report].

A 63-year-old female with 3 years of hemodialysis and 1 year of joint pain was treated with calcimimetics and other drugs for a long time. The bone and joint pain did not improve, and the serum PTH continued to rise. The left thyroid nodule was found during the preoperative localization examination of parathyroid gland. Preoperative examination showed that PTH 1258.9 ng/L, Ca 2.48 mmol/L, P 2.32 mmol/L, ALB 36.70 g/L, ALP 227.00 IU/L. Cervical ultrasonography showed thyroid nodules in the left lobe（TI-RADS 4b）, parathyroid hyperplasia and enlargement, and abnormal lymph nodes in the Ⅲ region of the left neck. Postoperative pathology: ①Thyroid papillary carcinoma on the left side, the size of the tumor was about 0.7 cm; ②There were 3 lymph nodes in Ⅲ region, of which 1 showed metastasis, and 1 consistent with sarcoidosis; ③4 parathyroid glands showed proliferative lesions, including the formation of pseudotumor-like nodules on the left upper parathyroid gland with hyperparathyroidism and no cancer invasion; ④There were 6 lymph nodes in the central region, of which 3 showed metastasis; ⑤There was 1 prelaryngeal lymph node and showed metastasis; ⑥There were 8 lymph nodes in Ⅱ region, of which 1 showed metastasis; ⑦There were 21 lymph nodes in Ⅳ region, all of which had no metastasis.