[Experience of parathyroid cancer which required a differentiation from adenoma]

A case was a 67-year-old man, who presented an inferior limb lassitude approximately in January 2009. We noted a thyroid gland mass by examination and referred for a further checkup. Biochemical examination of blood showed hypercalcemia, a high iPTH level of 2,190. The cervical echography evidence showed a mass image of the border regular in the back of inferior pole of left thyroid gland. It also revealed a mass image with the calcification in the inferior pole of left lobe of thyroid gland at the same time. We performed aspiration biopsy cytology for a thyroid gland mass, and it was class IIIa. We also performed parathyroidectomy and left lobe of thyroid gland ablative surgery because of a diagnosis of the hyperparathyroidism confirmed a primary parathyroid adenoma. Preoperative pathological diagnosis was adenoma. However, histopathology laboratory findings showed it to be of adenocarcinoma of the parathyroid, which metastasized into the thyroid. Many times parathyroid cancer preoperative diagnosis is inconclusive. So we are reporting our experience with parathyroid cancer metastases to the thyroid for reference.