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Coexistence of thyroid carcinoma and secondary hyperparathyroidism

Koinzidenz von Schilddrüsenkarzinom und sekundärem Hyperparathyreoidismus

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Summary

Background

Reports on the coexistence of secondary hyperparathyroidism (sHPT) and thyroid carcinoma are very rare.

Methods

A case of secondary hyperparathyroidism and concomitant papillary thyroid carcinoma (follicular variant) is described, and compared to data from the literature.

Results

1 out of 26 patients undergoing parathyroidectomy for secondary hyperparathyroidism had papillary thyroid microcarcinoma (follicular variant) associated with regional lymph node metastases. Head and neck were not irradiated during the patient’s case history. Dialysis had been performed for 23 years prior to simultaneous near-total thyroidectomy, total parathyroidectomy and autotransplantation. The prolonged high parathyroid hormone levels, or massive hemosiderin deposits may have caused the development of carcinoma. The incidence rate of occult thyroid microcarcinoma in all autopsies of our geographical region and period was 4.5 per cent.

Conclusions

Careful exploration of the thyroid gland, and liberal indication for biopsy of suspicious thyroid areas is mandatory in each sHPT patient who is operated on, in order to exclude possible thyroid carcinomas.

Zusammenfassung

Grundlagen

In der Literatur gibt es nur wenige Berichte über das gemeinsame Vorkommen von sekundärem Hyperparathyreoidismus (sHPT) und Schilddrüsenkarzinom.

Methodik

Ein Fall von sekundärem Hyperparathyreoidismus mit gleichzeitigem papillärem Schilddrüsenkarzinom (follikuläre Variante) wird beschrieben und mit Literaturdaten verglichen.

Ergebnisse

Unter 26 Patienten, die wegen sHPT operiert wurden, fand sich eine Patientin mit papillärem Mikrokarzinom (follikuläre Variante) und Lymphknotenmetastasen. Anamnestisch wurde keine Bestrahlung der Kopf-Halsregion durchgeführt. Die erhöhten Parathormonwerte und die massiven Hämosiderinablagerungen während der 23 Jahre langen Hämodialyse könnten die Ursache für die Karzinomentstehung sein. Neben einer totalen Parathyroidektomie mit simultaner Autotransplantation wurde eine „near-total” Thyroidektomie durchgeführt. In derselben geographischen Region wurden im gleichen Zeitraum bei 4,5% aller Autopsien Mikrokarzinome der Schilddrüse beobachtet.

Schlußfolgerungen

Bei jeder Halsexploration wegen sHPT ist immer die Schilddrüse sorgfältig nach einem Schilddrüsenkarzinom zu untersuchen und suspekte Schilddrüsenareale sind gegebenenfalls zu biopsieren.

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References

  1. Balázs G, Krasznai G: Orvosi Hetilap. Hung Med Weekly 1971;115:2856–2860.

    Google Scholar 

  2. Carreire MC, Turrion F, Renedo G, et al: Associacion de hiperparatiroidismo y carcinoma no medular de tiroides. Boln Fund Jimenez Diaz 1983;10:79–84.

    Google Scholar 

  3. Digenis G, Pierratos A, Oreopoulos DG: Cancer and chronic renal failure Editorial. Can Med Assoc J 1986;135:14–16.

    CAS  Google Scholar 

  4. Fedorak IJ, Satti G, Fulton N, et al. Increased incidence of thyroid cancer in patients with primary hyperparathyroidism: a continuing dilemma. Am Surg 1994;60:427–439.

    PubMed  CAS  Google Scholar 

  5. Foley RJ, Hammer RW: Hyperthyroidism in end-stage renal disease. Am J Nephrol 1987;5:292–295.

    Google Scholar 

  6. Inone S, Azuma M, Hirabayashi T, et al: Studies on small thyroid carcinoma in dialysis patients with hyperparathyroidism. Nippon Naibunpi Gakkai Zasshi 1986;62:1194–1202.

    Google Scholar 

  7. Krause U, Olbricht T, Metz K, et al. Koinzidenz von nicht-medullärem Schilddrüsencarcinom und Hyperparathyreoidismus. Chirurg 1991;62:536–539.

    PubMed  CAS  Google Scholar 

  8. Linder A, Fareqell VT, Sherrard DJ: High incidence of neoplasia in uremic patients receiving long-term dialysis. Nephron 1981;27:292–296.

    Google Scholar 

  9. Linos DA, van Heerden JA, Edis AJ: Primary hyperparathyroidism and non-medullary thyroid cancer. Am J Surg 1982;143:301–303.

    Article  PubMed  CAS  Google Scholar 

  10. Linos DA, Ziroyannis PN: Secondary hyperparathyroidism and thyroid cancer. Int Surg 1985;70:263–264.

    PubMed  CAS  Google Scholar 

  11. Matas AJ, Simmons RL, Kjellstrand CW, et al: Increased incidence of malignancy during chronic renal failure. Lancet 1975;19:883–886.

    Article  Google Scholar 

  12. McKillop JH Leung ACT, Wilson R. Successful management of Graves’ disease in a patient undergoing regular dialysis therapy. Arch Intern Med 1985;145:337.

    Article  PubMed  CAS  Google Scholar 

  13. Miki H, Oshimo K, Inone H, et al: Thyroid carcinoma in patients with secondary hyperparathyroidism. J Surg Oncol 1992;49:168–171.

    Article  PubMed  CAS  Google Scholar 

  14. Morrish DW, Filipov LJ, McEwan AJ, et al. I-131 treatment of thyroid papillary carcinoma in a patient with renal failure. Cancer 1990;66:2509–2513.

    Article  PubMed  CAS  Google Scholar 

  15. Roma J, Carrió J, Pascual R, et al. Spontaneous parathyroid hemorrhage in a hemodialysis patient. Nephron 1985;39:66–67.

    Article  PubMed  CAS  Google Scholar 

  16. Soffer O, Chary KR, Hall WD: Clinical hyperthyroidism in a patient receiving long-term hemodialysis. Arch Intern Med 1980;140:708–709.

    Article  PubMed  CAS  Google Scholar 

  17. Stevens RG, Jones DY, Micozzi MS, Taylor PR: Body iron stores and the risk of cancer. N Engl J Med 1988;19:1047–1052.

    Article  Google Scholar 

  18. Strichartz SD, Giuliano AE: The operative management of coexisting thyroid and parathyroid disease. Arch Surg 1990;125:1327–1331.

    PubMed  CAS  Google Scholar 

  19. Tezelman S, Rodriguez JM, Shen W, et al: Primary hyperparathyroidism in patients who have received radiation therapy and in patients who have not received radiation therapy. J Am Coll Surg 1995;180:81–87.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. First Department of Internal Medicine, School of Debrecen University, Hungary

    L. Ujhelyi & J. Mátyus

  2. Institute of Pathology of the Medical, School of Debrecen University, Hungary

    Sz Szakáll

  3. Department of Surgery of the University Medical School, P.O. Box 27, H-4012, Debrecen, Hungary

    G. L. Lukács M.D., D. Sc. & F. Györy

Authors
  1. G. L. Lukács M.D., D. Sc.
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  2. L. Ujhelyi
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  3. J. Mátyus
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  4. Sz Szakáll
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  5. F. Györy
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Lukács, G.L., Ujhelyi, L., Mátyus, J. et al. Coexistence of thyroid carcinoma and secondary hyperparathyroidism. Acta Chir Austriaca 28, 314–315 (1996). https://doi.org/10.1007/BF02629295

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