The role of ultrasound in the diagnosis of the coexistence of primary hyperparathyroidism and non-medullary thyroid carcinoma

Jian Shen,Yan Wang,Qiong Wu

doi:10.1186/s12880-019-0306-8

Abstract

BackgroundThe coexistence of primary hyperparathyroidism(PHPT) and papillary thyroid cancer(PTC) is a known entity; it is a rare and complicated setting for diagnostic imaging.MethodsAfter reviewing clinical data of 112 patients who had been treated for PHPT in our facility between January 2015 and December 2017, we identified 7 non-medullary thyroid carcinoma (NMTC) (6.25%). All of them had taken an ultrasound scan and undergone operation. In addition, we have also reviewed relevant reports from other facilities addressing PHPT and NMTC (Mainly PTC).ResultsThe 7 NMTCs were all pathologically confirmed PTC in our study, and they consisted of 6 parathyroid adenomas and 1 parathyroid carcinoma. 1 of the 7 patients had 2 malignant PTC nodules with neck lymph node metastasis, the rest 6 had single-focal PTC. Processing previous report data supported an association between PHPT and PTC, although the coexistence of PHPT and PTC is rare, but it does happen. Ultrasound, as an effective examination, would help screen the simultaneous lesions before operation, thus to avoid second surgery if not observed for both diseases at initial stage.ConclusionsUltrasound is a necessary choice for preoperative localization, because it has the ability to simultaneously examine the thyroid and parathyroid lesions.

Highlights

The coexistence of primary hyperparathyroidism(PHPT) and papillary thyroid cancer(PTC) is a known entity; it is a rare and complicated setting for diagnostic imaging
The coexistence of Primary hyperparathyroidism (PHPT) and Papillary thyroid carcinoma (PTC) is rare; and PHPT was usually considered as the primary pathology and was diagnosed before the identification of the thyroid carcinoma that was usually diagnosed in a pathology specimen as an incidental finding after parathyroid surgery
In most case reports describing the coexistence of these two lesions, PHPT was usually diagnosed before the identification of the thyroid carcinoma which was usually diagnosed in pathology specimen as an incidental finding after the surgery [2, 5, 6]

Summary

Introduction

The coexistence of primary hyperparathyroidism(PHPT) and papillary thyroid cancer(PTC) is a known entity; it is a rare and complicated setting for diagnostic imaging. The coexistence of primary hyperparathyroidism (PHPT) and non-medullary thyroid carcinoma (NMTC) was initially described by Ogburn and Black in 1956 According to their reports, 3 cases of synchronous PHPT and NMTC (including PTC and FTC) of the thyroid glands in patients operated for parathyroid adenoma was found [1]. The coexistence of PHPT and PTC is rare; and PHPT was usually considered as the primary pathology and was diagnosed before the identification of the thyroid carcinoma that was usually diagnosed in a pathology specimen as an incidental finding after parathyroid surgery Such phenomenon would further complicate the management process, especially resulting in the need of a second surgery [2]; a carefully preoperative imaging would be necessary. We present 7 cases of synchronous PHPT and PTC, trying to explore the significance of ultrasound in preoperative localization; relevant reports from other research centers addressing PHPT and NMTC (Mainly PTC) were reviewed

Methods

Results

Conclusion