Abstract
A 52year-old woman was admitted to the hospital because of an anterior neck swelling and palpitation, Ca and Ca-ion were 11.7 mg/dl and 2.84 mEq/l respectively. Tyroglobulin was 230 ng/ml. Lateral neck radiography revealed micro calcification in the thyroid gland. A 3.2 cm×2.2 cm mass in the left lobe and cystic lesion in the right lobe were recognized by ultrasonograms. Parathyroid tumors existed in the dorsal side of the left lower lobe on computed tomograms and dorsal side of the right lobe in magnetic resonance images. We suspected a thyroid carcinoma with adenomatous goiter associated with hyperparathyroidism. At operation total thyroidectomy with modified radical neck dissection for the thyroid carcinoma and total parathyroidectomy were performed. Histological diagnosis was papillary carcinoma with paratracheal lymph node metastasis and encapsulated follicular carcinoma on the resected tissue of the left lobe accompanied with adenomatous goiter. Then three parathyroid glands showed hyperplasia and another one did not. The postoperative couse was uneventful and has been no local recurrence nor distant metastasis, as of 5 years after the operation. No case of hyperparathyroidism with multiple thyroid lesions, papillary and follicular carcinomas, and adenomatous goiter has been seen in the literature as far as we could review.
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