An unusual presentation of coexisting parathyroid carcinoma and papillary carcinoma thyroid: a case report and literature review

Authors

  • Pradeep Puthen Veetil Department of Endocrine Surgery, Baby Memorial Hospital, Kozhikode, Kerala, India
  • Shikhil Puzhakkal Department of Endocrine Surgery, Baby Memorial Hospital, Kozhikode, Kerala, India
  • Niya Narayanan Department of Medical Endocrinology, Baby Memorial Hospital, Kozhikode, Kerala, India
  • Anju Chakko Department of Pathology, Baby Memorial Hospital, Kozhikode, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20230276

Keywords:

Parathyroid carcinoma, Papillary thyroid carcinoma, Hypercalcemia, PHPT

Abstract

Parathyroid carcinoma is the rarest endocrine cancer with aggressive behaviour. It may be presented as a feature of severe hypercalcemia, musculoskeletal involvement and a neck mass. There should be a high clinical suspicion if there is marked hypercalcemia, very high parathyroid hormone levels, palpable neck mass, recurrent laryngeal nerve palsy due to invasion and severe bone and renal symptoms. Thyroid pathology has been seen in 15-70% of patients with primary hyperparathyroidism (PHPT) especially with parathyroid adenoma. Medullary thyroid carcinoma is common with PHPT as in MEN 2 syndrome and rarely co-existed with non-medullary thyroid carcinoma. Parathyroid carcinoma and papillary thyroid carcinoma is extremely rare. Only 16 cases are reported in the literature.

References

Shane E. Parathyroid carcinoma. The Journal of Clinical Endocrinology & Metabolism. 2001 Feb 1;86(2):485-93.

Rodrigo JP, Hernandez-Prera JC, Randolph GW, Zafereo ME, Hartl DM, Silver CE, Suárez C, Owen RP, Bradford CR, Mäkitie AA, Shaha AR. Parathyroid cancer: An update. Cancer Treatment Reviews. 2020 Jun 1;86:102012.

De Quevain F. Malignant aberrant parathyroid. Dtsch Z Fuer Chir. 1904;100:334-52.

Quinn CE, Healy J, Lebastchi AH, Brown TC, Stein JE, Prasad ML, Callender GG, Carling T, Udelsman R. Modern experience with aggressive parathyroid tumors in a high-volume New England referral center. Journal of the American College of Surgeons. 2015 Jun 1;220(6):1054-62.

Kushchayeva Y, Duh QY, Kebebew E, D’Avanzo A, Clark OH. Comparison of clinical characteristics at diagnosis and during follow-up in 118 patients with Hurthle cell or follicular thyroid cancer. The American journal of surgery. 2008 Apr 1;195(4):457-62.

Dikmen K, Bostanci H, Gobut H, Yildiz A, Ertunc O, Celik A, Akin M, Taneri F. Nonfunctional double parathyroid carcinoma with incidental thyroid micropapillary carcinoma: a rare case. The Pan African Medical Journal. 2017;27.

Goldfarb M, O’Neal P, Shih JL, Hartzband P, Connolly J, Hasselgren PO. Synchronous parathyroid carcinoma, parathyroid adenoma, and papillary thyroid carcinoma in a patient with severe and long-standing hyperparathyroidism. Endocrine Practice. 2009 Jul 1;15(5):463-8.

Davies MP, Evans TW, Tahir F, Balasubramanian SP. Parathyroid cancer: A systematic review of diagnostic biomarkers. The Surgeon. 2021 Dec 1;19(6):e536-48.

Rodriguez C, Nadéri S, Hans C, Badoual C. Parathyroid carcinoma: a difficult histological diagnosis. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2012 Jun 1;129(3):157-9.

Leonard-Murali S, Ivanics T, Kwon DS, Han X, Steffes CP, Shah R. Local resection versus radical surgery for parathyroid carcinoma: A National Cancer Database analysis. European Journal of Surgical Oncology. 2021 Nov 1;47(11):2768-73.

Fingeret AL. Contemporary evaluation and management of parathyroid carcinoma. JCO oncology practice. 2021 Jan;17(1):17-21.

Limberg J, Stefanova D, Ullmann TM, Thiesmeyer JW, Bains S, Beninato T, Zarnegar R, Fahey TJ, Finnerty BM. The use and benefit of adjuvant radiotherapy in parathyroid carcinoma: a National Cancer Database Analysis. Annals of Surgical Oncology. 2021 Jan;28(1):502-11.

Lo WM, Good ML, Nilubol N, Perrier ND, Patel DT. Tumor size and presence of metastatic disease at diagnosis are associated with disease-specific survival in parathyroid carcinoma. Annals of surgical oncology. 2018 Sep;25(9):2535-40.

Spanheimer PM, Weigel RJ. Management of patients with primary hyperparathyroidism and concurrent thyroid disease: an evolving field. Annals of surgical oncology. 2012 May;19(5):1428-9.

Kurita S, Mihashi S, Hirano M, Nakashima T, Tanimura A. Hyperfunctioning parathyroid carcinoma combined with papillary carcinoma of the thyroid gland--report of a case (author's transl). Nihon Gan Chiryo Gakkai Shi. 1979 Dec 1;14(7):1127-35.

Christmas TJ, Chapple CR, Noble JG, Milroy EJ, Cowie AG. Hyperparathyroidism after neck irradiation. British Journal of Surgery. 1988 Sep;75(9):873-4.

Savli H, Sevinc A, Sari R, Ozen S, Buyukberber S, Ertas E. Occult parathyroid carcinoma in a patient with papillary thyroid carcinoma and Hashimoto’s thyroiditis. Journal of endocrinological investigation. 2001 Jan;24(1):42-4.

Bednarek-Tupikowska G, Tołłoczko T, Tupikowski W, Bogdańska M, Karwacki J, Medraś M, Milewicz A. Coexistence of parathyroid carcinoma and non-medullary carcinoma of the thyroid. Medical science monitor: international medical journal of experimental and clinical research. 2001 May 1;7(3):448-56.

Schoretsanitis G, Melissas J, Kafousi M, Karkavitsas N, Tsiftsis DD. Synchronous parathyroid and papillary thyroid carcinoma: a case report. American journal of otolaryngology. 2002 Nov 1;23(6):382-5.

Kern M, Lee G, Robbins P, Bynevelt M, Watson P. Intracranial metastatic parathyroid carcinoma: Case report and review of the literature. Journal of neurosurgery. 2004 Dec 1;101(6):1065-9.

Lin SD, Tu ST, Hsu SR, Chang JH, Yang KT, Yang LH. Synchronous parathyroid and papillary thyroid carcinoma. Journal of the Chinese Medical Association. 2005 Feb 1;68(2):87-91.

Goldfarb M, O’Neal P, Shih JL, Hartzband P, Connolly J, Hasselgren PO. Synchronous parathyroid carcinoma, parathyroid adenoma, and papillary thyroid carcinoma in a patient with severe and long-standing hyperparathyroidism. Endocrine Practice. 2009 Jul 1;15(5):463-8.

Marcy PY, Thariat J, Sudaka A, Poissonnet G. Synchronous parathyroid and papillary thyroid carcinomas. Thyroid. 2009 Oct 1;19(10):1131-3.

Chaychi L, Belbruno K, Golding A, Memoli V. Unusual manifestation of parathyroid carcinoma in the setting of papillary thyroid cancer. Endocrine Practice. 2010 Jul 1;16(4):664-8.

Amoodi HA, Makki FM, Taylor M, Bullock MJ, Hart RD, Trites JR. Synchronous Thyroid/parathyroid Carcinomas. Journal of Otolaryngology-Head & Neck Surgery= Le Journal D'oto-rhino-laryngologie et de Chirurgie Cervico-faciale. 2010 Oct 1;39(5):E42-7.

Zakerkish M, Rajaei E, Dargahi M, Bahadoram M. A rare constellation of Hürthle cell thyroid carcinoma and parathyroid carcinoma. Journal of Clinical and Diagnostic Research: JCDR. 2015 Dec;9(12):OD08.

Song C, Wang J, Cai X, Gao L. Synchronous parathyroid carcinoma and papillary thyroid carcinoma: a case study and review of literature. International Journal of Clinical and Experimental Pathology. 2016 Jan 1;9(1):302-9.

Baek CO, Kim KH, Song SK. Synchronous parathyroid carcinoma and papillary thyroid carcinoma in a patient with long-standing schizophrenia. The Korean Journal of Internal Medicine. 2017 Nov;32(6):1104.

Kuzu F, Cinkaya A, Ekici MF, Kodaz H, Deger A. Synchronous parathyroid carcinoma and multifocal papillary thyroid carcinoma: a case report. Eurasian Journal of Medicine and Oncology. 2017;1(1):49-52.

Lam-Chung CE, Rodríguez-Orihuela DL, Anda González JD, Gamboa-Domínguez A. An unusual simultaneous existence of parathyroid carcinoma and papillary thyroid carcinoma: case report and review of literature. Case Reports in Endocrinology. 2020 Mar 31;2020.

Downloads

Published

2023-01-27

Issue

Section

Case Reports