J Endocr Surg.  2018 Jun;18(2):161-166. 10.16956/jes.2018.18.2.161.

Primary Hyperparathyroidism, Concomitant Thyroid Papillary and Follicular Carcinomas on the Background of Hashimoto's: Interplay?

• Milk DG
• Vaknine H
• Cinamon U

• KMID: 2420771
• DOI: http://doi.org/10.16956/jes.2018.18.2.161

Abstract

Concomitant appearing of varied histological types of primary, well differentiated thyroid carcinoma simultaneously in the same patient is a rare condition. Furthermore, Hashimoto's thyroiditis (HT) and hyperparathyroidism due to parathyroid adenoma were both described as associated with thyroid cancer. Hereby, a case report of a patient with various, synchronous, thyroid disorders. A 53-year-old female presented with both papillary and follicular carcinoma of the thyroid, HT and primary hyperparathyroidism, all these pathologies occurring synchronically. Although, what may be anecdotal, propose an intriguing theoretical possible interplay. In addition, a short relevant auxiliary review and discussion is presented.

Keyword

Thyroid carcinoma; Follicular; Thyroid carcinoma; Papillary; Primary hyperparathyroidism; Hashimoto Thyroiditis

MeSH Terms

Female
Hashimoto Disease
Humans
Hyperparathyroidism
Hyperparathyroidism, Primary*
Middle Aged
Parathyroid Neoplasms
Pathology
Thyroid Gland*
Thyroid Neoplasms
Thyroiditis

Figure

• 

  Fig. 1 99mTc-MIBI scan. A suspected adenoma was located in vicinity to the inferior-medial left thyroid gland (arrows). 99mTc-MIBI = technetium-99m methoxyisobutylisonitrile imaging.

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  Fig. 2 Hürthle cell carcinoma showing invasion of tumor through the thick capsule at 2 foci highlighted by the black arrows (hematoxylin and eosin ×20).

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  Fig. 3 Close-up view of the papillary carcinoma demonstrating a single papilla at the center of the field and the characteristic cytological features of papillary carcinoma (nuclear crowding, nuclear groves, and chromatin clearing) (hematoxylin and eosin ×200).

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  Fig. 4 Close up view of the non-tumoral thyroid parenchyma showing germinal center formation at the lower left, dense lymphoplasmocytic infiltration and small atrophic follicles with large oncocytic cytoplasm (arrows) compatible with Hashimoto's thyroiditis. (hematoxylin and eosin ×100).

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  Fig. 5 Histologic picture of parathyroid gland demonstrating markedly increased cellularity and almost complete absence of adipocytes. Compatible with parathyroid adenoma (hematoxylin and eosin ×40).

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