유두상 갑상선 암종이 동반된 부갑상선 증식증 1예
Synchronous Papillary Thyroid Carcinoma and Parathyroid Hyperplasia
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Primary hyperparathyroidism (pHPT) and concomitant thyroid cancer is rare. The possibility of a coincidental appearance of pHPT and nonmedullary thyroid cancer is often neglected. We report a 50-year-old man with primary hyperparathyroidism with incidental papillary thyroid cancer. In this patient, preoperative imaging studies revealed the presences of a parathyroid tumor at left thyroid bed and both thyroid nodules. After left inferior parathyroidectomy, frozen section pathology suggested parathyroid hyperplasia. We performed left hemithyroidectomy and right paratracheal exploration. Frozen section biopsy of right paratracheal lymph node revealed metastatic lymph node of papillary thyroid cancer, so we performed total thyroidectomy with subtotal parathyroidectomy, and central compartment neck dissection. Permanent pathology revealed parathyroid hyperplasia with concurrent papillary thyroid carcinoma. A head and neck endocrine surgeon needs to be aware of the possible coexistence of thyroid and parathyroid pathologies and have to evaluate the thyroid gland in patients undergoing surgery for parathyroid disease
Abstract
Primary hyperparathyroidism (pHPT) and concomitant thyroid cancer is rare. The possibility of a coincidental appearance of pHPT and nonmedullary thyroid cancer is often neglected. We report a 50-year-old man with primary hyperparathyroidism with incidental papillary thyroid cancer. In this patient, preoperative imaging studies revealed the presences of a parathyroid tumor at left thyroid bed and both thyroid nodules. After left inferior parathyroidectomy, frozen section pathology suggested parathyroid hyperplasia. We performed left hemithyroidectomy and right paratracheal exploration. Frozen section biopsy of right paratracheal lymph node revealed metastatic lymph node of papillary thyroid cancer, so we performed total thyroidectomy with subtotal parathyroidectomy, and central compartment neck dissection. Permanent pathology revealed parathyroid hyperplasia with concurrent papillary thyroid carcinoma. A head and neck endocrine surgeon needs to be aware of the possible coexistence of thyroid and parathyroid pathologies and have to evaluate the thyroid gland in patients undergoing surgery for parathyroid disease
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