Case Discussion Parathyroid adenoma vs carcinoma 3.02.2020

Are thyroid and parathyroid lesions wrongly reported in a thyroid  pathology sample?

Does ultrasound help to differentiate adenoma lesions from parathyroid carcinoma?

Parathyroid carcinoma is rare, representing<1% of primary hyperparathyroidism cases.

Parathyroid carcinoma (PC) is an uncommon malignancy,

less than 1000 recorded cases reported in literature since described

by de Quervain in 1904

We report a 50-year-old male patient who was referred to our department for a right thyroid nodule, incidentally detected on carotid Doppler ultrasound scan, with a fine-needle aspiration cytology showing a follicular lesion. At the time of our evaluation, neck ultrasound showed a 1.3 cm right hypoechoic thyroid nodule with irregular margins and the absence of enlarged bilateral cervical lymph nodes. Thyroid function tests were normal. Serum calcium was normal and plasma PTH slightly above the upper limit of the normal range. The patients underwent right lobectomy. The intraoperative frozen-section pathological examination raised the suspicion of a PC. Definitive histology showed a markedly irregular infiltrative growth of the tumor with invasion of the thyroid tissue and cervical soft tissues.

Retrospective data of patients referred for evaluation of parathyroid disease between 2001 and 2018 were reviewed. The goal was to describe the clinical presentation, histopathologic characteristics, and treatment outcomes of parathyroid carcinoma.