J Korean Soc Radiol.  2015 May;72(5):319-323. 10.3348/jksr.2015.72.5.319.

Intrathyroidal Parathyroid Carcinoma: A Case Report

• You WY
• Han YM
• Choi YH

• KMID: 1793887
• DOI: http://doi.org/10.3348/jksr.2015.72.5.319

Abstract

Parathyroid carcinoma is an uncommon malignancy and a rare cause of primary hyperparathyroidism. Intrathyroidal parathyroid carcinoma is even rarer and only few cases have been reported previously. A 33-year-old woman presented with hypercalcemia. CT scan revealed a 5-cm sized intrathyroid nodule with a positive beak sign on the surface in contact with the thyroid gland. The patient underwent total thyroidectomy, and the histopathologic examination confirmed the diagnosis of parathyroid carcinoma. We report a case of intrathyroidal parathyroid carcinoma with brief literature review.

MeSH Terms

Adult
Animals
Beak
Diagnosis
Female
Humans
Hypercalcemia
Hyperparathyroidism, Primary
Parathyroid Neoplasms*
Thyroid Gland
Thyroid Nodule
Thyroidectomy
Tomography, X-Ray Computed
Ultrasonography

Figure

• 

  Fig. 1 A 33-year-old woman with intrathyroidal parathyroid carcinoma. Axial (A) and longitudinal (B) ultrasonogram shows a well marginated mixed echoic mass in left thyroid. On color Doppler ultrasonogram (C), marked increased vascularity is noted in left thyroid mass. Axial enhanced CT (D) reveals a well-marginated, heterogeneous enhancing mass in left thyroid gland. Coronal enhanced CT (E) shows an elongated left thyroid mass with a positive beak sign on the surface in contact with the thyroid gland. Parathyroid technetium-99m methoxyisobutylisonitrile scans (F). (Left) A 20-minute image shows diffuse even uptake by the left thyroid mass similar to that of the adjacent normal thyroid parenchyma. (Right) On a 2-hour delayed image, diffuse washout is noted in the both thyroid glands and left thyroid mass without definite focal abnormal hot uptake. Immunohistochemical staining (× 200) (G) for antiparathyroid hormone reveals strong parathyroid hormone expression in the resected tumor (upper portion). On histopathologic examination (H&E, × 200) (H), tumor cells (arrows) are found in the vascular space suggesting vascular invasion.

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