Management of the Central Compartment in Well-Differentiated Thyroid Carcinoma

Abstract Background Parathyroid carcinoma is a rare endocrine malignancy, rarer when synchronous with a non medullary well differentiated thyroid carcinoma. Parathyroid carcinoma accounts of 0.005% of all malignant tumors and it is responsible for less than 1% of primary hyperparathyroidism. The intrathyroidal localization of a parathyroid gland is not frequent with a reported prevalence of 0.2%. Carcinoma of parathyroids with intrathyroidal localization represents an even rarer finding, reported in only 16 cases described in literature. The rare constellation of synchronous parathyroid and thyroid carcinomas has prompted us to report our experience and perform literature review. Case presentation We herein report a case of a 63-years-old man with multinodular goiter and biochemical diagnosis of hyperparathyroidism. Total thyroidectomy with radio-guide technique using gamma probe after intraoperative sesta-MIBI administration and intraoperative PTH level was performed. The high radiation levels in the posterior thyroid lobe discovered an intrathyroidal parathyroid. Microscopic examination revealed a parathyroid main cell carcinoma at the posterior thyroidal left basal lobe, a classic papillary carcinoma at the same lobe and follicular variant of papillary carcinoma at the thyroidal right lobe. To the best of our knowledge, this is the first case documenting a synchronous multicentric non medullary thyroid carcinomas and intrathyroidal parathyroid carcinoma. Conclusions Our experience was reported and literature review underlining challenging difficulties in diagnostic workup and surgical management was carried out.

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Galectin-3, a marker of well-differentiated thyroid carcinoma, is expressed in thyroid nodules with cytological atypia

Histopathology ◽

10.1046/j.1365-2559.2002.01304.x ◽

2002 ◽

Vol 40 (1) ◽

pp. 80-87 ◽

Cited By ~ 52

Author(s):

A Coli ◽

G Bigotti ◽

F Zucchetti ◽

F Negro ◽

G Massi

Keyword(s):

Thyroid Carcinoma ◽

Thyroid Nodules ◽

Differentiated Thyroid Carcinoma ◽

Cytological Atypia ◽

Galectin 3 ◽

Well Differentiated

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Prognostic Factors in Patients with Multiple Recurrences of Well-Differentiated Thyroid Carcinoma

Journal of Oncology ◽

10.1155/2009/650340 ◽

2009 ◽

Vol 2009 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Theresa Holler ◽

Jenna Theriault ◽

Richard J. Payne ◽

Jonathan Clark ◽

Spiro Eski ◽

...

Keyword(s):

Prognostic Factors ◽

Thyroid Carcinoma ◽

Univariate Analysis ◽

Mount Sinai Hospital ◽

Differentiated Thyroid Carcinoma ◽

Multiple Treatment ◽

Time To Recurrence ◽

Stage Disease ◽

Well Differentiated ◽

Multiple Recurrences

Introduction.Patients with multiple recurrences of well-differentiated thyroid carcinoma (WDTC) have markedly reduced overall survival when compared with those who have 1 recurrence of their disease. The purpose of this investigation is to identify prognostic factors for mortality in this subgroup.Methods.Patients with multiple recurrences of WDTC were retrospectively identified from the thyroid cancer database at Mount Sinai Hospital, Toronto (1963–2000). Data on patient, tumor, and recurrence characteristics were collected, and each patient was given aMACIS score.Results.A total of 31 patients were identified (11 male, 20 female; 16–83 years). Using univariate analysis, age 45, stage disease, distant metastasis, vascular invasion, MACIS score 6, and time to recurrence of 12 months were found to be significant predictors for mortality in this subgroup.Conclusions.Patients with multiple recurrences of WDTC follow a distinct clinical course, marked with multiple treatment failures and a substantial risk of mortality.

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