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Published in: BMC Medical Imaging 1/2019

Open Access 01-12-2019 | Ultrasound | Research article

The role of ultrasound in the diagnosis of the coexistence of primary hyperparathyroidism and non-medullary thyroid carcinoma

Authors: Jian Shen, Qiong Wu, Yan Wang

Published in: BMC Medical Imaging | Issue 1/2019

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Abstract

Background

The coexistence of primary hyperparathyroidism(PHPT) and papillary thyroid cancer(PTC) is a known entity; it is a rare and complicated setting for diagnostic imaging.

Methods

After reviewing clinical data of 112 patients who had been treated for PHPT in our facility between January 2015 and December 2017, we identified 7 non-medullary thyroid carcinoma (NMTC) (6.25%). All of them had taken an ultrasound scan and undergone operation. In addition, we have also reviewed relevant reports from other facilities addressing PHPT and NMTC (Mainly PTC).

Results

The 7 NMTCs were all pathologically confirmed PTC in our study, and they consisted of 6 parathyroid adenomas and 1 parathyroid carcinoma. 1 of the 7 patients had 2 malignant PTC nodules with neck lymph node metastasis, the rest 6 had single-focal PTC. Processing previous report data supported an association between PHPT and PTC, although the coexistence of PHPT and PTC is rare, but it does happen. Ultrasound, as an effective examination, would help screen the simultaneous lesions before operation, thus to avoid second surgery if not observed for both diseases at initial stage.

Conclusions

Ultrasound is a necessary choice for preoperative localization, because it has the ability to simultaneously examine the thyroid and parathyroid lesions.
Literature
1.
go back to reference Ogburn Pl Fau - Black BM. Primary hyperparathyroidism and papillary adenocarcinoma of the thyroid; report of four cases. 1956(0092-699X (Print)). Ogburn Pl Fau - Black BM. Primary hyperparathyroidism and papillary adenocarcinoma of the thyroid; report of four cases. 1956(0092-699X (Print)).
2.
go back to reference Lehwald N, Cupisti K, Krausch M, Ahrazoglu M, Raffel A, Knoefel WT. Coincidence of primary hyperparathyroidism and nonmedullary thyroid carcinoma. Horm Metab Res. 2013;45(9):660–3.CrossRef Lehwald N, Cupisti K, Krausch M, Ahrazoglu M, Raffel A, Knoefel WT. Coincidence of primary hyperparathyroidism and nonmedullary thyroid carcinoma. Horm Metab Res. 2013;45(9):660–3.CrossRef
3.
go back to reference Wilson SD, Doffek KM, Wang TS, Krzywda EA, Evans DB, Yen TW. Primary hyperparathyroidism with a history of head and neck irradiation: the consequences of associated thyroid tumors. Surgery. 2011;150(4):869–77.CrossRef Wilson SD, Doffek KM, Wang TS, Krzywda EA, Evans DB, Yen TW. Primary hyperparathyroidism with a history of head and neck irradiation: the consequences of associated thyroid tumors. Surgery. 2011;150(4):869–77.CrossRef
4.
go back to reference Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid Cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid Cancer. Thyroid. 2015;2015:1557–9077 (electronic). Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid Cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid Cancer. Thyroid. 2015;2015:1557–9077 (electronic).
5.
go back to reference Aşik M, Anaforoǧlu I, Köse M, Karyagar S, Mollamehmetoǧlu B, Algün E. Papillary thyroid carcinoma with primary hyperparathyroidism: a report of two cases and a brief literature review. Turkish J Endocrinol Metab. 2013;17(1):12–4.CrossRef Aşik M, Anaforoǧlu I, Köse M, Karyagar S, Mollamehmetoǧlu B, Algün E. Papillary thyroid carcinoma with primary hyperparathyroidism: a report of two cases and a brief literature review. Turkish J Endocrinol Metab. 2013;17(1):12–4.CrossRef
6.
go back to reference Polyzos SA, Anastasilakis AD, Iakovou IP, Partsalidou V. Primary hyperparathyroidism and incidental multifocal metastatic papillary thyroid carcinoma in a man. Arq Bras Endocrinol Metabol. 2010;54(6):578–82.CrossRef Polyzos SA, Anastasilakis AD, Iakovou IP, Partsalidou V. Primary hyperparathyroidism and incidental multifocal metastatic papillary thyroid carcinoma in a man. Arq Bras Endocrinol Metabol. 2010;54(6):578–82.CrossRef
7.
go back to reference Linos DA, van Heerden JA, Edis AJ. Primary hyperparathyroidism and nonmedullary thyroid cancer. Am J Surg. 1982;143(3):301–3.CrossRef Linos DA, van Heerden JA, Edis AJ. Primary hyperparathyroidism and nonmedullary thyroid cancer. Am J Surg. 1982;143(3):301–3.CrossRef
8.
go back to reference Attie JN, Vardhan R. Association of hyperparathyroidism with nonmedullary thyroid carcinoma: review of 31 cases. Head Neck. 1993;15(1):20–3.CrossRef Attie JN, Vardhan R. Association of hyperparathyroidism with nonmedullary thyroid carcinoma: review of 31 cases. Head Neck. 1993;15(1):20–3.CrossRef
9.
go back to reference Burmeister LA, Sandberg M, Carty SE, Watson CG. Thyroid carcinoma found at parathyroidectomy: association with primary, secondary, and tertiary hyperparathyroidism. Cancer. 1997;79(8):1611–6.CrossRef Burmeister LA, Sandberg M, Carty SE, Watson CG. Thyroid carcinoma found at parathyroidectomy: association with primary, secondary, and tertiary hyperparathyroidism. Cancer. 1997;79(8):1611–6.CrossRef
10.
go back to reference Bentrem DJ, Angelos P, Talamonti MS, Nayar R. Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism? Thyroid. 2002;12(12):1109–12.CrossRef Bentrem DJ, Angelos P, Talamonti MS, Nayar R. Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism? Thyroid. 2002;12(12):1109–12.CrossRef
11.
go back to reference Arciero CA, Shiue ZS, Gates JD, Peoples GE, Dackiw AP, Tufano RP, et al. Preoperative thyroid ultrasound is indicated in patients undergoing parathyroidectomy for primary hyperparathyroidism. J Cancer. 2012;3:1–6.CrossRef Arciero CA, Shiue ZS, Gates JD, Peoples GE, Dackiw AP, Tufano RP, et al. Preoperative thyroid ultrasound is indicated in patients undergoing parathyroidectomy for primary hyperparathyroidism. J Cancer. 2012;3:1–6.CrossRef
12.
go back to reference Sidhu S, Campbell P. Thyroid pathology associated with primary hyperparathyroidism. Aust N Z J Surg. 2000;70(4):285–7.CrossRef Sidhu S, Campbell P. Thyroid pathology associated with primary hyperparathyroidism. Aust N Z J Surg. 2000;70(4):285–7.CrossRef
13.
go back to reference Gul K, Ozdemir D, Korukluoglu B, Ersoy PE, Aydin R, Ugras SN, et al. Preoperative and postoperative evaluation of thyroid disease in patients undergoing surgical treatment of primary hyperparathyroidism. Endocr Pract. 2010;16(1):7–13.CrossRef Gul K, Ozdemir D, Korukluoglu B, Ersoy PE, Aydin R, Ugras SN, et al. Preoperative and postoperative evaluation of thyroid disease in patients undergoing surgical treatment of primary hyperparathyroidism. Endocr Pract. 2010;16(1):7–13.CrossRef
14.
go back to reference Niedźwiecki S, Kuzdak K, Kaczka K, Pomorski L. Normocalcemic, subclinical, asymptomatic primary hyperparathyroidism in patients with goiter or papillary thyroid cancer--preliminary report. Normocalcemic primary hyperparathyroidism and thyroid pathology. Wiadomości lekarskie (Warsaw, Poland : 1960). 2007;60(5–6):228–30. Niedźwiecki S, Kuzdak K, Kaczka K, Pomorski L. Normocalcemic, subclinical, asymptomatic primary hyperparathyroidism in patients with goiter or papillary thyroid cancer--preliminary report. Normocalcemic primary hyperparathyroidism and thyroid pathology. Wiadomości lekarskie (Warsaw, Poland : 1960). 2007;60(5–6):228–30.
15.
go back to reference Cohen J, Gierlowski TC, Schneider AB. A prospective study of hyperparathyroidism in individuals exposed to radiation in childhood. JAMA. 1990;264(5):581–4.CrossRef Cohen J, Gierlowski TC, Schneider AB. A prospective study of hyperparathyroidism in individuals exposed to radiation in childhood. JAMA. 1990;264(5):581–4.CrossRef
16.
go back to reference Stephen AE, Chen KT, Milas M, Siperstein AE. The coming of age of radiation-induced hyperparathyroidism: evolving patterns of thyroid and parathyroid disease after head and neck irradiation. Surgery. 2004;136(6):1143–53.CrossRef Stephen AE, Chen KT, Milas M, Siperstein AE. The coming of age of radiation-induced hyperparathyroidism: evolving patterns of thyroid and parathyroid disease after head and neck irradiation. Surgery. 2004;136(6):1143–53.CrossRef
17.
go back to reference Woll M, Sippel RS, Chen H. Does previous head and neck irradiation increase the chance of multigland disease in patients with hyperparathyroidism? Ann Surg Oncol. 2011;18(8):2240–4.CrossRef Woll M, Sippel RS, Chen H. Does previous head and neck irradiation increase the chance of multigland disease in patients with hyperparathyroidism? Ann Surg Oncol. 2011;18(8):2240–4.CrossRef
18.
go back to reference Beebeejaun M, Chinnasamy E, Wilson P, Sharma A, Beharry N, Bano G. Papillary carcinoma of the thyroid in patients with primary hyperparathyroidism: is there a link? Med Hypotheses. 2017;103:100–4.CrossRef Beebeejaun M, Chinnasamy E, Wilson P, Sharma A, Beharry N, Bano G. Papillary carcinoma of the thyroid in patients with primary hyperparathyroidism: is there a link? Med Hypotheses. 2017;103:100–4.CrossRef
19.
go back to reference Leitha T, Staudenherz A. Concomitant hyperparathyroidism and nonmedullary thyroid cancer, with a review of the literature. Clin Nucl Med. 2003;28(2):113–7.PubMed Leitha T, Staudenherz A. Concomitant hyperparathyroidism and nonmedullary thyroid cancer, with a review of the literature. Clin Nucl Med. 2003;28(2):113–7.PubMed
20.
go back to reference Nam M, Jeong HS, Shin JH. Differentiation of parathyroid carcinoma and adenoma by preoperative ultrasonography. Acta Radiol. 2017;58(6):670–5.CrossRef Nam M, Jeong HS, Shin JH. Differentiation of parathyroid carcinoma and adenoma by preoperative ultrasonography. Acta Radiol. 2017;58(6):670–5.CrossRef
21.
go back to reference Hedman I, Tisell LE. Associated hyperparathyroidism and nonmedullary thyroid carcinoma: the etiologic role of radiation. Surgery. 1984;95(4):392–7.PubMed Hedman I, Tisell LE. Associated hyperparathyroidism and nonmedullary thyroid carcinoma: the etiologic role of radiation. Surgery. 1984;95(4):392–7.PubMed
22.
go back to reference Nishiyama RH, Farhi D, Thompson NW. Radiation exposure and the simultaneous occurrence of primary hyperparathyroidism and thyroid nodules. Surg Clin N Am. 1979;59(1):65–75.CrossRef Nishiyama RH, Farhi D, Thompson NW. Radiation exposure and the simultaneous occurrence of primary hyperparathyroidism and thyroid nodules. Surg Clin N Am. 1979;59(1):65–75.CrossRef
23.
go back to reference Strichartz SD, Giuliano AE. The operative management of coexisting thyroid and parathyroid disease. Arch Surg. 1990;125(10):1327–31.CrossRef Strichartz SD, Giuliano AE. The operative management of coexisting thyroid and parathyroid disease. Arch Surg. 1990;125(10):1327–31.CrossRef
24.
go back to reference Prinz RA, Barbato AL, Braithwaite SS, Brooks MH, Emanuele MA, Gordon DL, et al. Simultaneous primary hyperparathyroidism and nodular thyroid disease. Surgery. 1982;92(3):454–8.PubMed Prinz RA, Barbato AL, Braithwaite SS, Brooks MH, Emanuele MA, Gordon DL, et al. Simultaneous primary hyperparathyroidism and nodular thyroid disease. Surgery. 1982;92(3):454–8.PubMed
25.
go back to reference Krause UC, Friedrich JH, Olbricht T, Metz K. Association of primary hyperparathyroidism and non-medullary thyroid cancer. Eur J Surg. 1996;162(9):685–9.PubMed Krause UC, Friedrich JH, Olbricht T, Metz K. Association of primary hyperparathyroidism and non-medullary thyroid cancer. Eur J Surg. 1996;162(9):685–9.PubMed
26.
go back to reference LiVolsi VA, Feind CR. Parathyroid adenoma and nonmedullary thyroid carcinoma. Cancer. 1976;38(3):1391–3.CrossRef LiVolsi VA, Feind CR. Parathyroid adenoma and nonmedullary thyroid carcinoma. Cancer. 1976;38(3):1391–3.CrossRef
27.
go back to reference Phillips DJ, Kutler DI, Kuhel WI. Incidental thyroid nodules in patients with primary hyperparathyroidism. Head Neck. 2014;36(12):1763–5.CrossRef Phillips DJ, Kutler DI, Kuhel WI. Incidental thyroid nodules in patients with primary hyperparathyroidism. Head Neck. 2014;36(12):1763–5.CrossRef
28.
go back to reference Morita SY, Somervell H, Umbricht CB, Dackiw AP, Zeiger MA. Evaluation for concomitant thyroid nodules and primary hyperparathyroidism in patients undergoing parathyroidectomy or thyroidectomy. Surgery. 2008;144(6):862–6 discussion 866-868.CrossRef Morita SY, Somervell H, Umbricht CB, Dackiw AP, Zeiger MA. Evaluation for concomitant thyroid nodules and primary hyperparathyroidism in patients undergoing parathyroidectomy or thyroidectomy. Surgery. 2008;144(6):862–6 discussion 866-868.CrossRef
29.
go back to reference Xue Y, Ye ZQ, Zhou HW, Shi BM, Yi XH, Zhang KQ. Serum calcium and risk of nonmedullary thyroid Cancer in patients with primary hyperparathyroidism. Med Sci Monit. 2016;22:4482–9.CrossRef Xue Y, Ye ZQ, Zhou HW, Shi BM, Yi XH, Zhang KQ. Serum calcium and risk of nonmedullary thyroid Cancer in patients with primary hyperparathyroidism. Med Sci Monit. 2016;22:4482–9.CrossRef
30.
go back to reference Beus KS, Stack BC. Synchronous thyroid pathology in patients presenting with primary hyperparathyroidism. Am J Otolaryngol. 2004;25(5):308–12.CrossRef Beus KS, Stack BC. Synchronous thyroid pathology in patients presenting with primary hyperparathyroidism. Am J Otolaryngol. 2004;25(5):308–12.CrossRef
Metadata
Title
The role of ultrasound in the diagnosis of the coexistence of primary hyperparathyroidism and non-medullary thyroid carcinoma
Authors
Jian Shen
Qiong Wu
Yan Wang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2019
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/s12880-019-0306-8

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