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Simultaneous Primary Hyperparathyroidism and Thyroid Carcinomas: Rare Case Study

By: Cordi Craig
Posted: Friday, November 20, 2020

A research team led by Yao et al from Hebei Medical University, China, reported a rare case of a patient diagnosed with a combination of parathyroid adenoma, medullary thyroid carcinoma, and papillary thyroid carcinoma. The study results, published in the International Journal of Clinical & Experimental Pathology, concluded that patients with coexisting diseases should be carefully screened to avoid redundant surgeries. To ensure thorough patient evaluations, the research team suggested that clinicians perform preoperative checks of calcium levels in patients with thyroid cancer and preoperative thyroid checks in all patients with primary hyperparathyroidism.

A 64-year-old woman was admitted to the Xingtai People’s Hospital after 2 weeks of presenting aggravated symptoms of hypodynamia. Her medical history included diabetes and a kidney stone (left side). The bloodwork taken upon admission showed hypercalcemia, hypophosphatemia, and elevated serum parathyroid hormone. Further testing revealed dominant nodules in both the right and left lobes with a left inferior suspected parathyroid adenoma.

The patient underwent fine-needle aspiration of the bilateral thyroid lobes, which revealed thyroid carcinoma. The researchers subsequently performed a thyroidectomy, a neck dissection, and excision of a suspected parathyroid adenoma. She was diagnosed with a combination of parathyroid adenoma, medullary thyroid carcinoma, and papillary thyroid carcinoma. The serum levels of calcium and parathyroid hormones returned to a normal range following surgery. Although this coexistence is rare, the results indicated that clinicians should consider it in patients with primary hyperparathyroidism.

“To date, this case demonstrates the need for clinical alertness to comorbidities and the importance of a preoperative diagnosis of the diseases described here,” the research team concluded.

Disclosure: The study authors reported no conflicts of interest.

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