An Unusual case of recurent hyperparathyroidism and papillary thyroid cancer

Shane Y. Morita, Noel A. Brownlee, Alan P B Dackiw, William H. Westra, Douglas P. Clark, Martha A. Zeiger

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6 Scopus citations

Abstract

Objective: To report an unusual occurrence of recurrent hyperparathyroidism due to papillary thyroid carcinoma. Methods: We describe the clinical history, physical examination findings, laboratory values, imaging findings, and pathologic findings of a woman who developed recurrent hyperparathyroidism 13 years after successful parathyroidectomy. Results: A 59-year-old woman presented to our clinic with recurrent primary hyperparathyroidism. In 1994, she presented with nephrolithiasis and underwent resection of a right superior parathyroid adenoma that resulted in clinical and biochemical cure. Her clinical course had been followed at periodic intervals, and she had been symptom-free and normocalcemic. In 2007, she again developed nephrolithiasis and was documented to have recurrent hyperparathyroidism. Imaging studies suggested a parathyroid adenoma near the right inferior pole of the thyroid. The patient had reoperative neck exploration. No obvious parathyroid adenoma was found and a right thyroid lobectomy was performed, which resulted in normalization of intraoperative intact parathyroid hormone levels, and the incision was closed. Final pathology demonstrated no parathyroid adenoma, but instead, a 1-cm papillary thyroid carcinoma that stained positive for parathyroid hormone. More than 6 months after surgery, she remains clinically and biochemically cured.Conclusions: Recurrent hyperparathyroidism occurs secondary to multiple causes. This case demonstrates the challenge a surgeon faces in managing recurrent disease and highlights a rare phenomenon of papillary thyroid cancer causing recurrent hyperparathyroidism. (Endocr Pract. 2009;15:349-352).

Original languageEnglish (US)
Pages (from-to)349-352
Number of pages4
JournalEndocrine Practice
Volume15
Issue number4
DOIs
StatePublished - May 1 2009

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Morita, S. Y., Brownlee, N. A., Dackiw, A. P. B., Westra, W. H., Clark, D. P., & Zeiger, M. A. (2009). An Unusual case of recurent hyperparathyroidism and papillary thyroid cancer. Endocrine Practice, 15(4), 349-352. https://doi.org/10.4158/EP08145.CRR1