Benign and malignant thyroid tumors are more frequent in the right thyroid lobe, presumably due to its larger size

Intrathyroidal parathyroid carcinoma is an exceedingly rare cause of primary hyperparathyroidism. A 51-year-old African American female presented with goiter, hyperparathyroidism, and symptomatic hypercalcemia. Sestamibi scan revealed diffuse activity within an enlarged thyroid gland with uptake in the right thyroid lobe suggestive of hyperfunctioning parathyroid tissue. The patient underwent thyroidectomy and parathyroidectomy. At exploration, a 2.0 cm nodule in the usual location of the right inferior parathyroid was sent for intraoperative frozen consultation, which revealed only ectopic thyroid tissue. No parathyroid glands were identified grossly on the external aspect of the thyroid. Interestingly, postoperative parathyroid hormone levels normalized after removal of the thyroid gland. Examination of the thyroidectomy specimen revealed a 1.4 cm parathyroid nodule located within the parenchyma of the right superior thyroid, with capsular and vascular invasion and local infiltration into surrounding thyroid tissue. We present only the eighth reported case of intrathyroidal parathyroid carcinoma and review the literature.

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Thyroid Metastases from Renal Cell Carcinoma: Review of the Literature

The Scientific World JOURNAL ◽

10.1100/tsw.2010.55 ◽

2010 ◽

Vol 10 ◽

pp. 590-602 ◽

Cited By ~ 28

Author(s):

Alessandro Sindoni ◽

Massimo Rizzo ◽

Giovanni Tuccari ◽

Antonio Ieni ◽

Valeria Barresi ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cancer ◽

Renal Cell ◽

Left Kidney ◽

Thyroid Lobe ◽

Thyroid Metastasis ◽

Side Preference ◽

Thyroid Metastases ◽

The Right

The thyroid gland is a rare site of clinically detectable tumor metastasis and kidneys are frequently the site of the parent malignancy. In the present review on thyroid metastases from renal cell carcinoma, cases were searched on PubMed by entering the strings: “renal carcinoma [or“hypernephroma”] AND thyroid metastasis/metastases”. Thus, we retrieved a total of 111 cases that were published between 1964 and 2007, a total that became 113 by adding two patients observed by us. The female to male ratio was 1.35:1. The primary renal cancer was almost always unilateral (90%) (with no significant side preference) and only rarely bilateral (9% in men, 4% in women), whereas bilaterality of thyroid metastases was relatively more frequent (28%). Thyroid metastasis from renal cancer was commonly single with a unique node that appears solid and hypoechoic at ultrasonography, approximately 9 years after nephrectomy. Concordance of lateralization was insignificantly greater for the right kidney/right thyroid lobe pattern (54%) than for the left kidney/left thyroid lobe pattern (40%), regardless of gender. Finally, survival was longer for women. Thyroid metastases, even if rare in the clinical practice, must be considered in the differential diagnosis of a thyroid nodule, particularly in patients who have a history of malignancies.

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SAT-367 A Case Series: Discovery of Parathyroid Carcinoma During Parathyroidectomy for Primary Hyperparathyroidism

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1551 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Chellse Gazda ◽

Jessica Abramowitz ◽

Marconi Abreu

Keyword(s):

Vitamin D ◽

Bone Density ◽

Recurrent Laryngeal Nerve ◽

Parathyroid Carcinoma ◽

Laryngeal Nerve ◽

Normal Range ◽

Thyroid Lobe ◽

Urine Calcium ◽

Neck Ultrasound ◽

The Right

Abstract Introduction: Parathyroid carcinoma is rare and represents <1% of patients diagnosed with hyperparathyroidism (1). Clinical Cases: We present two cases of incidentally diagnosed parathyroid carcinoma during parathyroidectomy for primary hyperparathyroidism. A 69-year-old female was referred for hypercalcemia of 10.7 mg/dL (normal range 8.4-10.2). She had bone pain, fatigue, and mild depression. She was taking triamterene-hydrochlorothiazide, vitamin D 2000 international units daily, and 1 caltrate daily. Her thiazide diuretic was discontinued, and a repeat calcium was 9.5 mg/dL with a PTH of 79 pg/mL (normal range 14-64). Vitamin D and renal function were normal. A 24 hour urine calcium was elevated at 706 mg/24 hours (normal range 100-321). A bone density revealed osteopenia. Based on the high urine calcium, a thyroid ultrasound was completed and showed an enlarged right parathyroid gland. Intraoperatively, the surgeon found a superior parathyroid gland adherent to the local soft tissues with recurrent laryngeal nerve entrapment. The right superior parathyroid and right thyroid lobe were resected. Pathology demonstrated an infiltrating parathyroid carcinoma. Postoperative monitoring has included: calcium, creatinine, PTH and neck ultrasound every six months without evidence of recurrence. A 79-year-old man was referred for an approximate 18-month history of hypercalcemia. He had a prior kidney stone and constipation. He was not on calcium supplementations or thiazides. On lab testing calcium was 11.0 mg/dl with prior levels of 11.7 mg/dl. PTH was 246 pg/ml and vitamin D was 20.1 ng/ml (normal range 30-80). Imaging was obtained for parathyroid localization. A neck ultrasound and nuclear medicine study showed a right inferior parathyroid adenoma. A bone density revealed osteoporosis. Intraoperatively, the surgeon found a bilobed parathyroid extending intrathyroidal and adherent to the recurrent laryngeal nerve. The right inferior parathyroid, right thyroid lobe, and isthmus were resected. Pathology was consistent with parathyroid carcinoma. The patient had recurrent laryngeal nerve damage with persistent hoarseness postoperatively. Clinical Lessons: Patients with parathyroid carcinoma typically present with symptomatic hypercalcemia with mean levels of 13.5-14 mg/dL and mean PTH values 8.7 times the upper limit of normal (1). Given the rarity of the condition, there are no guidelines for surveillance (1). These cases highlight atypical, mild, and early presentations of an unusual and typically aggressive disease and serve as an example of how to monitor for recurrence. Reference: 1- Stack BC, Bodenner DL. Medical and Surgical Treatment of Parathyroid Diseases An Evidence-Based Approach. Switzerland: Springer, Cham; 2017.http://link.springer.com/chapter/10.10 07/978-3-319-26794-4_31#enumeration. Accessed November 3, 2019.

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Clinical observation of metastatic thyroid disease in a patient with breast cancer

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2018-46-4-379-383 ◽

2018 ◽

Vol 46 (4) ◽

pp. 379-383

Author(s):

E. V. Bondarenko ◽

L. E. Gurevich ◽

I. V. Kotova

Keyword(s):

Breast Cancer ◽

Thyroid Gland ◽

Thyroid Disease ◽

Progesterone Receptors ◽

Needle Aspiration ◽

Thyroid Tumors ◽

Breast Cancer Metastases ◽

Thyroid Goiter ◽

Diagnostic Panel ◽

The Right

Metastatic tumors of the thyroid gland (TG) are rare. Usually thyroid gland metastases originate from renal, lung, skin and gastrointestinal cancers. Breast cancer metastases are more rare and in various samples amount to 3 to 34% of all cases of the metastatic thyroid disease. We present a rare case of metastatic carcinomatosis into the thyroid goiter in a 63-year old female patient who has received combination therapy for breast cancer. In 2016, right-sided mastectomy was performed due to the right breast cancer (invasive carcinoma, non-specific type, Grade 2, with skin invasion) with subsequent four chemotherapy courses. A slowly growing nodule in the thyroid gland was first found in 2012; in 2017, fine needle aspiration biopsy was performed, which showed a follicular tumor that resulted in thyroidectomy. At the histological examination, against the background of thyroid goiter, multiple small lesions with advanced nuclear polymorphism were found, with doubtful diagnosis. To clarify the histogenesis of the tumor lesions, immunohistochemical assessment was performed. Its first phase included the markers of primary thyroid tumors (thyroglobulin, TTF-1), and the second one consisted of the breast cancer diagnostic panel (mammoglobin, GATA-3, estrogen and progesterone receptors). The results showed multiple small metastases of the invasive breast carcinoma of non-specific type into the thyroid goiter. Taking into account eventual problems of differential diagnosis and significant morphological polymorphism of thyroid tumors, we recommend extending of the immunohistochemistry panel in this patient category.

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Thyroid Hemiagenesis and Papillary Carcinoma: A Rare Association

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1041 ◽

2010 ◽

Vol 2 (3) ◽

pp. 145-147

Author(s):

Tammaro P ◽

Nunziante M ◽

Del Prete M ◽

Asciore L ◽

Nappi F ◽

...

Keyword(s):

Papillary Carcinoma ◽

Central Compartment ◽

Left Lobe ◽

Primary Hypothyroidism ◽

Rare Occurrence ◽

Thyroid Lobe ◽

Rare Association ◽

Thyroid Hemiagenesis ◽

The Right

ABSTRACT Hemiagenesis is the least frequent thyroid congenital anomaly. We report the case of a primary hypothyroidism due to thyroid hemiagenesis in a patient for whom, later on, a papillary carcinoma of the contralateral lobe was diagnosed. A child with known left lobe thyroid agenesis was found to have a 12 mm nodule in the right thyroid lobe during routine follow-up. Needle biopsy demonstrated the nodule to represent a papillary thyroid cancer and total thyroidectomy and lymphadenectomy of the central compartment was undertaken. Such event represents an extremely rare occurrence since there are only five other reports in literature that deal with a papillary carcinoma in a patient with thyroid hemiagenesis.

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Solitary Intrathyroid Metastasis Occurring 23 Years after Resection of Renal Cell Carcinoma

Case Reports in Endocrinology ◽

10.1155/2021/2735256 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

X. Vandemergel

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Needle Aspiration ◽

Thyroid Lobe ◽

Aspiration Cytology ◽

History Of ◽

Right Lobe ◽

Needle Aspiration Cytology ◽

The Right

A case of solitary intrathyroid metastasis is described in a 60-year-old male patient. He had a history of renal cell carcinoma classified as T1b resected 23 years earlier. A mass was palpable in the right thyroid lobe. Ultrasound showed a hypoechoic polylobular nodule with intense vascularisation in the right lobe. Fine needle aspiration cytology was normal, but thyroidectomy was performed due to mass enlargement, the ultrasound pattern, and the oncological history. Histological examination revealed the presence of an intrathyroid metastasis of renal cell carcinoma. The bone scan and thoracoabdominal CT scan were normal. Postoperative care was uneventful.

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Escisión transcervical de un adenoma paratiroideo mediastínico gigante

Studies in the Economic History of Southern Africa ◽

10.22201/fm.24484865e.2021.64.2.06 ◽

2021 ◽

Vol 64 (2) ◽

pp. 38-45

Author(s):

Isaías Adrián Barrientos López ◽

◽

Bertha Beatriz Castillo Ventura ◽

Keyword(s):

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Thyroid Lobe ◽

Selective Treatment ◽

Case Presentation ◽

Parathyroid Adenomas ◽

History Of ◽

Thyroid Profile ◽

The Right ◽

Similar Location

Primary hyperparathyroidism (HPTP) is the third most common neuroendocrine disorder, its main cause is parathyroid adenoma. Within the classification, those adenomas that weigh more than 3.5 g are classified as giant parathyroid adenomas (APG), and are associated with a worse evolution and malignancy. The purpose of this article is to present our diagnostic and therapeutic approach of a patient with HPTP ssociated with a mediastinal APG. A search in the international literature of the last 10 years revealed that only 8 other centers ha ve reported the extraction of an APG of similardimensions to ours and in a similar location. Case presentation: A 66-year-old woman with a history of multinodular goiter, thyroid profile and parathormone (PTH) measurement were requested, with a report of 350.60 pg/mL. A thyroid/parathyroid scintigraphy was performed with 99mTc sestaMIBI which reported persistence of a focal area of the concentration located in the topography of the lower pole of the right thyroid lobe. This study was complemented with SPECT-CT, which reported an image of hyperfunctioning right inferior parathyroid compatible with adenoma and the patient was diagnosed with PTH. Finally, resection was performed, obtaining a tumor measuring 7.0 × 4.5 × 2.0 cm, with a weight of 24.5 g. Conclusions: Our case highlights the use of imaging studies to facilitate localization and achieve diagnosis together with clinical presentation and biochemical profile. Selective treatment was achieved safely through a minimally invasive transcervical technique, combined with the measurement of PTH. Keywords: Parathyroid adenoma; neoplasia; hypercalcemia; primary hyperparathyroidism; case report.

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Blunt Trauma to the Thyroid: A Case Report

The American Surgeon ◽

10.1177/000313480507100615 ◽

2005 ◽

Vol 71 (6) ◽

pp. 518-521 ◽

Cited By ~ 10

Author(s):

Christine Weeks ◽

Francis D. Moore ◽

Stephen J. Ferzoco ◽

Jonathan Gates

Keyword(s):

Steering Wheel ◽

Trauma Symptoms ◽

Thyroid Lobe ◽

Neck Trauma ◽

Anterior Neck ◽

Acute Setting ◽

Early Intubation ◽

Blunt Neck Trauma ◽

Life Threatening ◽

The Right

Thyroid injury is a rare phenomenon in cases of blunt neck trauma. Symptoms are often subtle or not present on initial exam and can be rapidly life-threatening when airway compromise ensues. We describe the case of a 50-year-old woman who developed neck pain and swelling, dysphagia, and hoarseness after a rear-end collision in which she was the restrained driver, hitting her anterior neck against the steering wheel. Neck CT revealed fragmentation and hematoma within the right thyroid lobe. Arteriogram showed no vascular injury to the neck. The patient was observed in the ICU and was discharged home 3 days later without operative intervention. We believe that in the acute setting, a stable traumatic thyroid hematoma without airway encroachment may be safely observed. Increasing size or compromise of airway integrity should be indications for early intubation and neck exploration.

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Metachronous Colon Metastasis to the Thyroid: A Case Report and Literature Review

Case Reports in Surgery ◽

10.1155/2013/241678 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Dvir Froylich ◽

Eitan Shiloni ◽

David Hazzan

Keyword(s):

Thyroid Gland ◽

Colon Carcinoma ◽

Malignant Neoplasm ◽

Colon Resection ◽

The Body ◽

Thyroid Lobe ◽

Carcinoma Metastasis ◽

Thyroid Metastases ◽

The Right ◽

Metastatic Colon Carcinoma

The thyroid gland is a known site for metastatic tumors from various primary sites. Thyroid metastases are not an exceptional finding at autopsy, and they are encountered in 2% to 9% of the patients with malignant neoplasm. The most frequent tumors to metastasize are breast, lung, melanoma, and kidney carcinomas. Despite the fact that it is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of 3% of secondary malignances of this organ. Metastatic colon carcinoma to the thyroid gland has been reported, and it is not as rare as one might think. We present a very unique case of colon carcinoma metastasis to the right thyroid lobe and lung five years after colon resection, with reoccurrence two years later in the contralateral thyroid lobe. The literature regarding colon cancer metastasizing to the thyroid gland was reviewed with an attempt to disclose features of this presentation regarding patient’s prognosis.

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