Synchronous parathyroid adenoma and thyroid papillary carcinoma: a case report
1 3rd Academic Nuclear Department Papageorgiou Hospital, Thessaloniki, Greece
2 2nd Academic ORL Department Papageorgiou Hospital, Thessaloniki, Greece
3 Endocrinology Department, Theageneio Anticancer Institute, Thessaloniki, Greece
Cases Journal 2009, 2:9121 doi:10.1186/1757-1626-2-9121Published: 30 November 2009
A 51-year-old female patient presented with atypical chest pain, laryngo-oesophageal reflux, increased levels of serum calcium and parathyroid hormone. Ultrasonography showed a multinodular goiter with a prominent solid nodule in the lower left thyroid lobe and a solid hypoechoic nodule outside this area.
Tc99m-sestamibi parathyroid scintigraphy was performed to investigate a primary hyperparathyroidism, revealing an area with increased uptake in the lower left thyroid lobe and another area with marked uptake lower than this level. Thyroid scintigraphy with 99mTc showed a cold nodule of the left lower pole. FNA of the thyroid nodule was positive for papillary carcinoma later verified by postoperative histopathology.
This case underlines the need for a clinical high index of suspicion for synchronous hyperparathyroidism and thyroid cancer.