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

Research output: Contribution to journalArticle

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 2009

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Parathyroid Neoplasms
Hyperparathyroidism
Nephrolithiasis
Parathyroid Hormone
Thyroid Gland
Parathyroidectomy
Secondary Hyperparathyroidism
Primary Hyperparathyroidism
Physical Examination
Neck
Pathology
Papillary Thyroid cancer

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

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

An Unusual case of recurent hyperparathyroidism and papillary thyroid cancer. / Morita, Shane Y.; Brownlee, Noel A.; Dackiw, Alan P B; Westra, William H.; Clark, Douglas P.; Zeiger, Martha A.

In: Endocrine Practice, Vol. 15, No. 4, 05.2009, p. 349-352.

Research output: Contribution to journalArticle

Morita, SY, Brownlee, NA, Dackiw, APB, Westra, WH, Clark, DP & Zeiger, MA 2009, 'An Unusual case of recurent hyperparathyroidism and papillary thyroid cancer', Endocrine Practice, vol. 15, no. 4, pp. 349-352. https://doi.org/10.4158/EP08145.CRR1
Morita SY, Brownlee NA, Dackiw APB, Westra WH, Clark DP, Zeiger MA. An Unusual case of recurent hyperparathyroidism and papillary thyroid cancer. Endocrine Practice. 2009 May;15(4):349-352. https://doi.org/10.4158/EP08145.CRR1
Morita, Shane Y. ; Brownlee, Noel A. ; Dackiw, Alan P B ; Westra, William H. ; Clark, Douglas P. ; Zeiger, Martha A. / An Unusual case of recurent hyperparathyroidism and papillary thyroid cancer. In: Endocrine Practice. 2009 ; Vol. 15, No. 4. pp. 349-352.
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