Abstract
Parathyroid carcinoma is a rare malignancy, which usually occurs as a sporadic disease, and less frequently in the setting of genetic syndromes. Despite the association of parathyroid and thyroid disorders being quite common, the coexistence of parathyroid carcinoma and thyroid disease is rare. We reviewed the pertinent literature. The terms “parathyroid carcinoma” and “thyroid disease, hyperthyroidism, thyrotoxicosis, hypothyroidism, thyroid nodule(s), Graves’ disease, autonomously functioning thyroid nodules” were used both separately and in reciprocal conjunction to search MEDLINE for articles published from January 2007 to March 2016. The search was prompted by the observation of a never reported association of autonomously functioning thyroid nodules and parathyroid carcinoma. Two hundred and twenty-one parathyroid carcinoma patients have been described during the last 10 years. Neck ultrasonography and parathyroid scintigraphy are the most common instrumental studies used in detecting parathyroid lesions. Serum parathyroid hormone and calcium levels are high in the majority of parathyroid carcinoma patients. Only 21 patients with parathyroid carcinoma and thyroid disorders were found. Our patient is the first casual association between parathyroid carcinoma and autonomously functioning thyroid nodules reported in literature and diagnosed using parathyroid and thyroid scintigraphies. Parathyroid carcinoma is a very rare endocrine tumor and association with thyroid disease is not frequent. Parathyroid carcinoma pre-operative diagnosis is often difficult also because available literature data are not homogenous and there is not a common operative guideline. Our case confirms the role of parathyroid scintigraphy, encouraging the association with thyroid scintigraphy, especially in the presence of (multi)-nodular goiter in order to address the most appropriate surgical management.
Similar content being viewed by others
References
E. Shane, Clinical review 122: Parathyroid carcinoma. J. Clin. Endocrinol. Metab. 86, 485–493 (2001)
N. Talat, K.M. Schulte, Clinical presentation, staging and long-term evolution of parathyroid cancer. Ann. Surg. Oncol. 17, 2156–2174 (2010)
F. Cetani, E. Pardi, C. Marcocci, Update on parathyroid carcinoma. J. Endocrinol. Invest. 39, 595–606 (2016)
A. Agha, R. Carpenter, S. Bhattacharya, S.J. Edmonson, E. Carlsen, J.P. Monson, Parathyroid carcinoma in multiple endocrine neoplasia type 1 (MEN1) syndrome: two case reports of an unrecognised entity. J. Endocrinol. Invest. 30, 145–149 (2007)
A. Campennì, R.M. Ruggeri, A. Sindoni, S. Giovinazzo, L. Calbo, A. Ieni, M. Monaco, G. Tuccari, S. Benvenga, S. Baldari, Parathyroid carcinoma as a challenging diagnosis: report of three cases. Hormones (Athens) 3, 368–376 (2012)
A. Campennì, R.M. Ruggeri, A. Sindoni, S. Giovinazzo, E. Calbo, A. Ieni, L. Calbo, G. Tuccari, S. Baldari, S. Benvenga, Parathyroid carcinoma presenting as normocalcemic hyperparathyroidism. J. Bone Miner. Metab. 3, 367–372 (2012)
F. Cetani, G. Frustaci, L. Torregrossa, S. Magno, F. Basolo, A. Campomori, P. Miccoli, C. Marcocci, A non-functioning parathyroid carcinoma misdiagnosed as a follicular thyroid nodule. World J. Surg. Oncol. (2015). doi:10.1186/s12957-015-0672-9
F. Aghini-Lombardi, P. Vitti, L. Antonangeli, E. Fiore, A. Piaggi, E. Consiglio, A. Pinchera, Southern Italy study group for iodine deficiency disorders: The size of the community rather than its geographical location better defines the risk of iodine deficiency: results of an extensive survey in Southern Italy. J. Endocrinol. Invest. 36, 282–286 (2013)
T.M. Vicchio, S. Giovinazzo, R. Certo, M. Cucinotta, C. Micali, S. Baldari, S. Benvenga, F. Trimarchi, A. Campennì, R.M. Ruggeri, Lack of association between autonomously functioning thyroid nodules and germline polymorphisms of the thyrotropin receptor and Gas genes in a mild to moderate iodine-deficient Caucasian population. J. Endocrinol. Invest. 7, 625–630 (2014)
I.D. Hay, J.D. Morris. Toxic adenoma and toxic multinodular goiter. Werner and Ingbar’s The Thyroid. L.E. Braverman, R.D. Utiger (Lippincott-Raven, Philadelphia, 1996), pp. 566–572
M. Kebapci, E. Entok, N. Kebapci, B. Adapinar, Preoperative evaluation of parathyroid lesions in patients with concomitant thyroid disease: role of high resolution ultrasonography and dual phase technetium 99m sestamibi scintigraphy. J. Endocrinol. Invest. 27, 24–30 (2004)
S. Tseleni-Balafouta, H. Gakiopoulou, N. Kavantzas, G. Agrogiannis, N. Givalos, E. Patsouris, Parathyroid proliferations: a source of diagnostic pitfalls in FNA of thyroid. Cancer 111, 130–136 (2007)
H. Mazeh, D. Prus, H.R. Freund, Incidental non-functional parathyroid carcinoma identified during thyroidectomy. Isr. Med. Assoc. J. 10, 659 (2008)
M. Goldfarb, P. O’Neal, J.L. Shih, P. Hartzband, J. Connolly, P.O. Hasselgren, Synchronous parathyroid carcinoma, parathyroid adenoma, and papillary thyroid carcinoma in a patient with severe and long-standing hyperparathyroidism. Endocr. Pract. 15, 463–468 (2009)
P.Y. Marcy, J. Thariat, A. Sudaka, G. Poissonnet, Synchronous parathyroid and papillary thyroid carcinomas. Thyroid 19, 1131–1133 (2009)
L. Chaychi, K. Belbruno, A. Golding, V. Memoli, Unusual manifestation of parathyroid carcinoma in the setting of papillary thyroid cancer. Endocr. Pract. 16, 664–668 (2010)
H.A. Amoodi, F.M. Makki, S. Mark Taylor, M.J. Bullock, R.D. Hart, J.R. Trites, Synchronous thyroid/parathyroid carcinomas. J. Otolaryngol. Head Neck Surg. 39, 42–47 (2010)
S.I. Basceken, V. Genc, S. Ersoz, Y. Sevim, S.U. Celik, I.K. Bayram, Is local resection sufficient for parathyroid carcinoma? Clinics (Sao Paulo) 70, 247–249 (2015)
M. Zakerkish, E. Rajaei, M. Dargahi, M. Bahadoram, A rare constellation of Hürthle cell thyroid carcinoma and parathyroid carcinoma. J. Clin. Diagn. Res. 9, 8–10 (2015)
J.N. Talbot, F. Duron, T. Kiffel, B. Nordlinger, Association of parathyroid adenoma and autonomous nodule of the thyroid. Diagnostic efficacy of 201thallium-99mtechnetium scintigraphy. Eur. J. Nucl. Med. 12, 304–305 (1986)
D.J. Bentrem, P. Angelos, M.S. Talamonti, R. Nayar, Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism? Thyroid 12, 1109–1112 (2002)
E. Hindié, Ö. Ugur, D. Fuster, M. O’Doherty, G. Grassetto, A. Ureña Kettle, S.A. Gulec, F. Pons, D. Rubello, EANM parathyroid guidelines. Eur. J. Nucl. Med. Mol. Imaging 7, 1201–1216 (2009)
L. Foppiani, P. Del Monte, G. Sartini, A. Arlandini, P. Quilici, R. Bandelloni, A. Marugo, D. Bernasconi, Intrathyroidal parathyroid carcinoma as cause of hypercalcemia and pitfall of localization techniques: clinical and biologic features. Endocr. Pract. 13, 176–181 (2007)
G.G. Fernandez-Ranvier, E. Khanafshar, K. Jensen, R. Zarnegar, J. Lee, E. Kebebew, Q.Y. Duh, O.H. Clark, Parathyroid carcinoma, atypical parathyroid adenoma, or parathyromatosis? Cancer 110, 255–264 (2007)
I. Kruljac, I. Pavic, N. Matesa, G. Mirosevic, A. Maric, B. Becejac, M. Ivkic, D. Zadravec, K. Katinic, M. Vrkljan, Intrathyroid parathyroid carcinoma with intrathyroidal metastasis to the contralateral lobe: source of diagnostic and treatment pitfalls. Jpn. J. Clin. Oncol. 41, 1142–1146 (2011)
L. Vila Duckworth, W.E. Winter, M. Vaysberg, C.A. Moran, S.Z. Al-Quran, Intrathyroidal parathyroid carcinoma: report of an unusual case and review of the literature. Case Rep. Pathol. (2013). doi:10.1155/2013/198643
M. Diaconescu, M. Glod, I. Costea, M. Grigorovici, S. Diaconescu, Thyroid and thymic exeresis in surgery of hyperparathyroidism. Chirurgia (Bucur) 109, 747–752 (2014)
J. Cao, C. Chen, Q.L. Wang, J.J. Xu, M.H. Ge, Parathyroid carcinoma: a report of six cases with a brief review of the literature. Oncol. Lett. 10, 3363–3368 (2015)
K.S. Beus, B.C. Stack Jr, Synchronous thyroid pathology in patients presenting with primary hyperparathyroidism. Am. J. Otolaryngol. 5, 308–312 (2004)
H. Savli, A. Sevinc, R. Sari, S. Ozen, S. Buyukberber, E. Ertas, Occult parathyroid carcinoma in a patient with papillary thyroid carcinoma and Hashimoto’s thyroiditis. J. Endocrinol. Invest. 1, 42–44 (2001)
I.D. Kirkwood, B.E. Chatterton, P. Malycha, S. Guha, Autonomous thyroid adenoma, papillary thyroid carcinoma, and ectopic parathyroid adenoma in a patient with primary hyperparathyroidism and a nontoxic multinodular goiter. Clin. Nucl. Med. 7, 491–493 (1997)
He Y., S. Liu, H. Guo, B. Shi, Incidental finding of papillary thyroid carcinoma with BRAFV600E mutation in a patient with coexistent primary hyperparathyroidism and Graves’ hyperthyroidism. BMJ Case Rep. (2014). doi:10.1136/bcr-2013-203436
S. Wei, Z.W. Baloch, V.A. LiVolsi, Parathyroid adenoma in patients with Graves’ disease: a report of 21 cases. Endocr. Pathol. 1, 71–74 (2015)
C. Verdelli, I. Forno, V. Vaira, S. Corbetta, Epigenetic alterations in human parathyroid tumors. Endocrine 49, 324–332 (2015)
F. De Quervain, Parastruma maligna aberrata. Deutsche Zeitschr. Chir. 100, 334–352 (1904)
K.S. Beus, B.C. Stack Jr, Parathyroid carcinoma. Otolaryngol. Clin. North Am. 37, 845–854 (2004)
J.P. Givi, Shah parathyroid carcinoma. Clin. Oncol. (R. Coll. Radiol.) 22, 498–507 (2010)
C.H. Wei, A. Harari, Parathyroid carcinoma: update and guidelines for management. Curr. Treat. Options Oncol. 1, 11–23 (2012)
F. Medas, E. Erdas, G. Loi, F. Podda, G. Pisano, A. Nicolosi, P.G. Calò, Controversies in the management of parathyroid carcinoma: a case series and review of the literature. Int. J. Surg. 28, 94–98 (2016)
M. Halenka, D. Karasek, Z. Frysak, Four ultrasound and clinical pictures of parathyroid carcinoma. Case Rep. Endocrinol. (2012) doi:10.1155/2012/363690
A. Bhansali, S.R. Masoodi, S. Bhadaba, B.R. Mittal, A. Behra, P. Singh, Ultrasonography in detection of single and multiple abnormal parathyroid glands in primary hyperparathyroidism: comparison Clin. Endocrinol. (Oxf.) 65, 340–345 (2006)
R. Ersoy, O. Ersoy, B. Evranos Ogmen, S.B. Polat, M. Kilic, N. Yildirim, L. Ozturk, B. Cakir, Diagnostic value of endoscopic ultrasonography for preoperative localization of parathyroid adenomas. Endocrine 47, 221–226 (2014)
L. Giovanella, A. Campenni, G. Treglia, F.A. Verburg, P. Trimboli, L. Ceriani, M. Bongiovanni, Molecular imaging with (99m)Tc-MIBI and molecular testing for mutations in differentiating benign from malignant follicular neoplasm: a prospective comparison. Eur. J. Nucl. Med. Mol. Imaging 43, 1018–1026 (2016)
A. Campenni, L. Giovanella, M. Siracusa, A. Alibrandi, S. Pignata, S. Giovinazzo, F. Trimarchi, R.M. Ruggeri, S. Baldari, 99mTc-methoxy-isobutyl-isonitrile (MIBI) scintigraphy is a useful tool for assessing the risk of malignancy in thyroid nodules with indeterminate fine needle cytology (FNAC). Thyroid 26, 1101–1109 (2016)
D. Rubello, G. Saladini, D. Casara, N. Borsato, A. Toniato, A. Piotto, P. Bernante, M.R. Pelizzo, Parathyroid imaging with pertechnetate plus perchlorate/MIBI subtraction scintigraphy: a fast and effective technique. Clin. Nucl. Med. 7, 527–531 (2000)
F.Y. Tseng, Y.L. Hsiao, T.C. Chang, Ultrasound-guided fine needle aspiration cytology of parathyroid lesions. A review of 72 cases. Acta Cytol. 46, 1029–1036 (2002)
D. Abraham, P.K. Sharma, J. Bentz, P.M. Gault, L. Neumayer, D.A. McClain, Utility of ultrasound-guided fine-needle aspiration of parathyroid adenomas for localization before minimally invasive parathyroidectomy. Endocr. Pract. 13, 333–337 (2007)
I. Heo, S. Park, C.W. Jung, J.S. Koh, S.S. Lee, H. Seol, H.S. Choi, S.Y. Cho, Fine needle aspiration cytology of parathyroid lesions. Korean J. Pathol. 47, 466–471 (2013)
I. Bancos, C.S. Grant, S. Nadeem, M.N. Stan, C.C. Reading, T.J. Sebo, A. Algeciras-Schimnich, R.J. Singh, D.S. Dean, Risks and benefits of parathyroid fine-needle aspiration with parathyroid hormone washout. Endocr. Pract. 18, 441–449 (2012)
C. Spinelli, A.G. Bonadio, P. Berti, G. Materazzi, P. Miccoli, Cutaneous spreading of parathyroid carcinoma after fine needle aspiration cytology. J. Endocrinol. Invest. 23, 255–257 (2000)
Funding
This work was not supported by any grant.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests.
Authors’ contributions
Each author gave a substantial contribution to the paper and approved the final version to be published.
Informed consent
Informed consent was obtained.
Rights and permissions
About this article
Cite this article
Campennì, A., Giovinazzo, S., Pignata, S.A. et al. Association of parathyroid carcinoma and thyroid disorders: A clinical review. Endocrine 56, 19–26 (2017). https://doi.org/10.1007/s12020-016-1147-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12020-016-1147-7