scholarly journals Synchronous intrathyroidal parathyroid carcinoma and thyroid carcinoma: case report and review of the literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia De Falco ◽  
Giuseppe Santangelo ◽  
Fabrizio Chirico ◽  
Angelo Cangiano ◽  
Maria Giulia Sommella ◽  
...  

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.

2018 ◽  
Vol 20 (2) ◽  
pp. 99
Author(s):  
Faria Nasreen ◽  
Nurun Nahar ◽  
Sadia Sultana

<p><strong><em>Background:</em></strong> Thyroid carcinoma is rare in childhood and adolescence. The presentation is more advanced in case of children as compared to adults. However, the prognosis for survival in children is reportedly excellent. The aim of the study was to see the outcome of patients with well differentiated thyroid carcinoma during childhood and adolescence treated at a single institute.</p><p><strong><em>Patients and methods:</em></strong> A retrospective study of 61 children and adolescent patients (age ≤18years) with well differentiated thyroid carcinoma (DTC) enrolled in the National Institute of Nuclear Medicine and Allied Sciences, Dhaka during the period of  January1986  up to December 2007 was carried out. To allow for a theoretical follow up of at least 5 years the last inclusion year was 2007 and follow up was carried on up to June 2013. All patients were treated by thyroidectomy followed by radioiodine ablation therapy. Whole body scans, Tg, anti Tg Ab and neck ultrasound findings were recorded six months to one year after initial therapy to classify patients into remission, persistent or recurrent disease. Status on last follow up was noted to estimate the survival rate.</p><p><strong><em>Results:</em></strong> A total of 40 patients had papillary carcinoma, 18 had follicular variant of papillary carcinoma (FVPCT) and three had follicular carcinoma. Age range at diagnosis was nine to 18 years with a mean of 15± 2 years. The number of patients ≤10 years were five and &gt; 10 years were 56. There were 12 males and 49 females giving a M: F ratio of about 1:4. Among the 61 patients 30 patients had lymph node metastases and two had both nodal and lung metastases at initial presentation. After one year follow up from the initial radioiodine therapy, 30 patients were in remission and 31 patients had persistent disease. Eventually recurrence occurred in five patients. Three patients died during the whole observation period and all of them were cancer related giving a cancer specific mortality ratio of 0.049%, 95% CI 0 to 0.105%. Cancer specific survival by Kaplan-Meier curve was 98.2%, 98.2% and 66% at 5, 10 and 15 years respectively.</p><p><strong><em>Conclusion:</em></strong> DTC in children and adolescent has a good prognosis in the presence of neck and distant metastases. Awareness of the patient and regular follow up with life long surveillance is essential to obtain a favorable outcome.</p><p>Bangladesh J. Nuclear Med. 20(2): 99-104, July 2017</p>


2019 ◽  
Vol 104 (7-8) ◽  
pp. 304-313
Author(s):  
Chih-Yiu Tsai ◽  
Shu-Fu Lin ◽  
Szu-Tah Chen ◽  
Chuen Hsueh ◽  
Yann Sheng Lin ◽  
...  

Objective The aim of this study was to evaluate outcomes of the recurrent and non-recurrent groups including disease-specific mortality of patients with well-differentiated thyroid carcinoma after multimodality treatment. In addition, prognostic factors for disease-specific mortality were analyzed. Summary of Background Data Among 2,844, there were 166 patients with recurrent disease. Recurrent disease was defined as the presence of papillary or follicular thyroid cancer 6 months after the initial thyroidectomy, including locoregional or distant metastasis, diagnosed using diagnostic or therapeutic 131I scans or other imaging techniques. Methods The study was a retrospective analysis of prospectively collected data for a long-term follow-up result of well-differentiated thyroid carcinoma patients. Results The mean age of 166 patients was 45.8 ± 1.2 years, 116 (69.9%) were women, 111 (66.9%) had locoregional neck recurrence, and 55 (33.1%) had metastatic recurrence in distant organs. We found that when recurrences were observed, more than half were detected within the first 5 years following the initial therapy. The longest period of time before relapse was 29.8 years. After a mean follow-up period of 12.7 ± 0.5 years, 37 (22.3%) patients experienced disease-specific mortality. Multivariable analysis revealed that older age, male sex, and development of a second primary malignancy were associated with disease-specific mortality. Higher post-operative levels of thyroglobulin predicted a shorter time to relapse. Conclusions These data indicate that among the recurrent cases over 50% of recurrent well-differentiated thyroid carcinomas were diagnosed within 5 years after initial thyroidectomy. Additionally, more than 20% of the patients died of thyroid cancer.


2014 ◽  
Vol 71 (11) ◽  
pp. 1078-1080 ◽  
Author(s):  
Jelena Eremija ◽  
Tatjana Milenkovic ◽  
Katarina Mitrovic ◽  
Sladjana Todorovic ◽  
Rade Vukovic ◽  
...  

Introduction. Differentiated thyroid carcinoma (DTC) is a rare childhood malignancy, as it represents 0.3-0.4% of pediatric malignancies. Papillary carcinoma is the most common type of pediatric DTC and it represents about 90% of all DTC patients. Although rare, DTC arising from dyshormonogenetic goiter is the most serious complication of congenital hypothyroidism. Case report. We presented the development of thyroid papillary carcinoma in a 15-year-old girl diagnosed with congenital dyshormonogenetic hypothyroidism at neonatal age. Considering the early initiation and proper dosage of hormonal substitution, normal levels of thyreotropin and thyroid hormones were achieved quickly and maintained through a follow-up period. The girl remained euthyroid and asymptomatic until 13.8 years of age, when she presented with a large multinodular goiter. The patient underwent total thyroidectomy. Pathological examination revealed intrathyroid microcarcinoma in the right lobe. Conclusion. Although differentiated thyroid carcinoma is a rare pediatric malignancy, it is of great importance to have a certain degree of clinical caution and provide a multidisciplinary approach during the follow-up of patients with dyshormonogenetic hypothyroidism.


2016 ◽  
Vol 17 (2) ◽  
pp. 114-119
Author(s):  
Faria Nasreen ◽  
Nurun Nahar ◽  
Sadia Sultana ◽  
Faridul Alam

Background: There is no maximum limit for cumulative dose of I-131 for persistent disease in well-differentiated thyroid carcinoma (DTC) patients. However, most remissions are obtained with cumulative activity equal to or lower than 600 mCi (22 GBq). On the other hand a significantly increased risk of leukemia and secondary cancers has been reported with high cumulative dose of I-131 (? 600 mCi). Above this cumulative activity further radioiodine therapy should be taken on an individualized basis.Objective: The aim of the study was to see the outcome of patients with well differentiated thyroid carcinoma receiving a cumulative doses (CDs) of ? 600 mCi I-131.Patient and Method: A retrospective study of 72 patients with DTC receiving a CDs of ?600 mCi I-131 in the National Institute of Nuclear Medicine and Allied Sciences (NINMAS), Dhaka during the period of January 1994 up to December 2007 was carried out. Initially all patients were treated by thyroidectomy followed by radioiodine therapy as adjusted by standard protocol. The mean period of follow up was 8.9 ± 6 years.  From the medical files, age, gender, histopathological variant, thyroid remnant and radio ablation doses, follow up data were recorded. Age was further categorized as <45 and ?45 years. Thyroid bed remnant was designated as significant if the thyroid bed uptake was ?5% after surgery. Dose was categorized in ?5 dose and > 5 doses to find its association with status on last follow up. Disease free (DF) was established as: undetectable or suppressed serum Tg levels <2.0 ng/mL and stimulated serum Tg level <10 ng/mL, two consecutive negative whole body scans.Results: A total of 38 patients had papillary carcinoma, eight had follicular variant of papillary carcinoma and 26 had follicular carcinoma. Age range at diagnosis was nine to 72 years. There were 22 males and 50 females giving a M: F ratio of about 1:2. Among the 72 patients 25 patients had lymph node metastases, eight had lung metastases and 20 had bone metastases at presentation. Twenty-one patients died during the whole observation period and 20 of them were cancer related. Two patients developed second malignancy.Conclusion: DTC patients with follicular variant, ? 45 years of age, having bone metastasis and significant thyroid remnant have less favourable outcome in spite of high cumulative doses of radioiodine. DTC patients with higher TNM stage and bone metastasis require higher and more radioiodine doses.Bangladesh J. Nuclear Med. 17(2): 114-119, July 2014


Author(s):  
Bernardo Marques ◽  
Raquel Martins ◽  
Joana Couto ◽  
Jacinta Santos ◽  
Teresa Martins ◽  
...  

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Theresa Holler ◽  
Jenna Theriault ◽  
Richard J. Payne ◽  
Jonathan Clark ◽  
Spiro Eski ◽  
...  

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.


2014 ◽  
Vol 15 (6) ◽  
pp. 817 ◽  
Author(s):  
Sun Jin Lee ◽  
So Lyung Jung ◽  
Bum Soo Kim ◽  
Kook Jin Ahn ◽  
Hyun Seok Choi ◽  
...  

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