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Rare Case of Concurrent Idiopathic Hypoparathyroidism and Papillary Thyroid Carcinoma

By: Sarah Campen, PharmD
Posted: Friday, February 5, 2021

An “extremely rare” case of idiopathic hypoparathyroidism combined with papillary thyroid carcinoma was reported in Frontiers in Endocrinology. To the authors’ knowledge, this was the first report of a patient with both disorders diagnosed simultaneously. “We hope that our report can serve as a reference for the diagnosis and treatment of similar patients in the future,” stated Jingqiang Zhu, MD, of the West China Hospital of Sichuan University, Chengdu, China, and colleagues.

In this case, a 22-year-old man presented with a 9-year history of uncontrollable extremity and facial numbness, spasm, and twitch. He had been misdiagnosed with epilepsy, with no relief from antiepileptic therapy. A laboratory evaluation revealed reduced parathyroid hormone and serum calcium levels and elevated inorganic phosphorus levels; after other possible etiologies were excluded, he was diagnosed with idiopathic hypoparathyroidism. A cervical ultrasound to evaluate the parathyroid glands inadvertently revealed a mass with irregular margins on the thyroid gland, which was later identified as papillary thyroid carcinoma.

Because the parathyroid glands are anatomically close to the thyroid, surgical intervention of the thyroid gland can often affect parathyroid function. However, the multidisciplinary team decided that active surveillance and thermal ablation were not viable options due to the size of the primary lesion. The patient underwent surgical removal of the lesion and radioactive iodine ablation to treat the papillary thyroid carcinoma. The long-term treatment strategy included oral levothyroxine for thyroid-stimulating hormone inhibition and oral calcium and vitamin D supplements for hypocalcemia control.

Disclosure: The authors reported no conflicts of interest.

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