Silent intrathyroid parathyroid carcinoma.

IF 0.7 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinology, Diabetes and Metabolism Case Reports Pub Date : 2023-05-01 DOI:10.1530/EDM-23-0027

Ekaterina Kim, Ekaterina Bondarenko, Anna Eremkina, Petr Nikiforovich, Natalia Mokrysheva

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引用次数: 0

Abstract

Summary: A 59-year-old male presented with an accidental thyroid mass in 2022. Ultrasound and CT scan showed a nodule 5.2 × 4.9 × 2.8 cm (EU-TIRADS 4) in the right lobe of the thyroid gland. Taking into account the results of the fine needle aspiration biopsy (Bethesda V), intrathyroid localization, and absence of clinical symptoms, a malignant tumor of the thyroid gland was suspected. The patient underwent total thyroidectomy using fluorescence angiography with indocyanine green, and two pairs of intact parathyroid glands were visualized in typical localization. Unexpected histological and immunohistochemistry examinations revealed parathyroid carcinoma. Due to the asymptomatic course of the disease and atypical localization of parathyroid tumor, primary hyperparathyroidism was not suspected before the surgery. The diagnosis of asymptomatic intrathyroid parathyroid cancer is a serious diagnostic challenge for a wide range of specialists.

Learning points: Parathyroid cancer is a rare disease that may be asymptomatic. Intrathyroidal localization of parathyroid carcinoma is casuistic and challenging for diagnosis, and the treatment strategy is not well defined. Preoperative parathyroid hormone and serum calcium testing are recommended for patients with solid thyroid nodules (Bethesda IV-V).

Abstract Image

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隐匿性甲状旁腺癌。

摘要:一名59岁男性于2022年出现意外甲状腺肿块。超声及CT示甲状腺右叶一5.2 × 4.9 × 2.8 cm结节(EU-TIRADS 4)。考虑到细针穿刺活检(Bethesda V)的结果、甲状腺内定位和无临床症状，怀疑甲状腺恶性肿瘤。患者行甲状腺全切除术，采用吲哚菁绿荧光血管造影，典型定位可见两对完整甲状旁腺。出乎意料的组织和免疫组织化学检查显示甲状旁腺癌。由于本病病程无症状，且甲状旁腺肿瘤定位不典型，术前未怀疑原发性甲状旁腺功能亢进。无症状甲状腺内甲状旁腺癌的诊断是一个严重的诊断挑战为广泛的专家。学习要点:甲状旁腺癌是一种罕见的疾病，可能没有症状。甲状旁腺癌的甲状腺内定位是一种模棱两可和具有挑战性的诊断，治疗策略也没有很好的定义。建议实性甲状腺结节患者术前进行甲状旁腺激素和血清钙检测(Bethesda IV-V)。

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来源期刊

Endocrinology, Diabetes and Metabolism Case Reports Medicine-Internal Medicine

CiteScore

1.50

自引率

0.00%

发文量

142

审稿时长

9 weeks

期刊介绍： Endocrinology, Diabetes & Metabolism Case Reports publishes case reports on common and rare conditions in all areas of clinical endocrinology, diabetes and metabolism. Articles should include clear learning points which readers can use to inform medical education or clinical practice. The types of cases of interest to Endocrinology, Diabetes & Metabolism Case Reports include: -Insight into disease pathogenesis or mechanism of therapy - Novel diagnostic procedure - Novel treatment - Unique/unexpected symptoms or presentations of a disease - New disease or syndrome: presentations/diagnosis/management - Unusual effects of medical treatment - Error in diagnosis/pitfalls and caveats