An atypical concurrent occurrence of parathyroid adenoma and micropapillary thyroid carcinoma: First case reported in Saudi Arabia.

Papillary thyroid carcinoma Parathyroid adenoma Surgical excision

Journal

International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872

Informations de publication

Date de publication:
May 2023
Historique:
received: 16 10 2022
revised: 03 04 2023
accepted: 11 04 2023
medline: 24 4 2023
pubmed: 24 4 2023
entrez: 24 04 2023
Statut: ppublish

Résumé

Papillary thyroid carcinoma (PTC) is the most frequent endocrine cancer and most common thyroid cancer. The concurrent occurrence of both tumors however is a very rare occasional finding. Surgical treatment via excision is the only definitive. Our study aims to highlight a rare occurrence of concurrent parathyroid adenoma and micropapillary thyroid carcinoma. We describe a 36-year-old female who presented to the outpatient clinic with a left thyroid nodule. Both a Tc-99m-MIBI parathyroid scan and Tc-99m thyroid scan were performed. A left total thyroidectomy was performed then subsequently the parathyroid adenoma was localized. Intra-operative parathyroid hormone decreased by >50 % from 531.5 pg/ml iPTH Stat to 39.8 pg/ml iPTH Stat which is diagnostic for proper localization. Two specimens were sent for histopathological evaluation. Histopathological evaluation of the first specimen confirmed the diagnosis of parathyroid adenoma. Histopathological evaluation of the second specimen revealed that the presence of papillary microcarcinoma of a size of 0.8 cm and pathologic staging to be pT1a, pNx, pMx. To our knowledge, this is the first case of concurrent occurrence of parathyroid adenoma and micropapillary thyroid carcinoma reported in the Kingdom of Saudi Arabia. Intraoperatively, management was done by via excision and confirmation of the parathyroid localization was done via intraoperative parathyroid hormone level measurement. We recommend more extensive studies to identify any possible patterns or predictors of finding these two concurrent tumors.

Sections du résumé

BACKGROUND BACKGROUND
Papillary thyroid carcinoma (PTC) is the most frequent endocrine cancer and most common thyroid cancer. The concurrent occurrence of both tumors however is a very rare occasional finding. Surgical treatment via excision is the only definitive. Our study aims to highlight a rare occurrence of concurrent parathyroid adenoma and micropapillary thyroid carcinoma.
CASE PRESENTATION METHODS
We describe a 36-year-old female who presented to the outpatient clinic with a left thyroid nodule. Both a Tc-99m-MIBI parathyroid scan and Tc-99m thyroid scan were performed. A left total thyroidectomy was performed then subsequently the parathyroid adenoma was localized. Intra-operative parathyroid hormone decreased by >50 % from 531.5 pg/ml iPTH Stat to 39.8 pg/ml iPTH Stat which is diagnostic for proper localization. Two specimens were sent for histopathological evaluation. Histopathological evaluation of the first specimen confirmed the diagnosis of parathyroid adenoma. Histopathological evaluation of the second specimen revealed that the presence of papillary microcarcinoma of a size of 0.8 cm and pathologic staging to be pT1a, pNx, pMx.
CONCLUSION CONCLUSIONS
To our knowledge, this is the first case of concurrent occurrence of parathyroid adenoma and micropapillary thyroid carcinoma reported in the Kingdom of Saudi Arabia. Intraoperatively, management was done by via excision and confirmation of the parathyroid localization was done via intraoperative parathyroid hormone level measurement. We recommend more extensive studies to identify any possible patterns or predictors of finding these two concurrent tumors.

Identifiants

pubmed: 37094415
pii: S2210-2612(23)00327-9
doi: 10.1016/j.ijscr.2023.108199
pmc: PMC10149331
pii:
doi:

Types de publication

Case Reports

Langues

eng

Pagination

108199

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interest Not applicable.

Auteurs

Ahmed Hafez Mousa (AH)

Department of Surgery, Saudi German Hospitals, Jeddah, Saudi Arabia; College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia. Electronic address: drahmedhafezmousa@gmail.com.

Moshiur Rahman (M)

Department of Surgery, Saudi German Hospitals, Jeddah, Saudi Arabia; College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.

Hussain Raeid Alsadeq (HR)

Department of Surgery, Saudi German Hospitals, Jeddah, Saudi Arabia; College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.

Zain Zuhair Albukhari (ZZ)

Department of Surgery, Saudi German Hospitals, Jeddah, Saudi Arabia; College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.

Abdullatif Sheikh Ibrahim (AS)

Department of Surgery, Saudi German Hospitals, Jeddah, Saudi Arabia; College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.

Islam Khaled (I)

Department of Surgery, Saudi German Hospitals, Jeddah, Saudi Arabia; Department of Surgery, Faculty of Medicine, Suez Canal University Hospitals, Ismailia, Egypt.

Classifications MeSH