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Large Parathyroid Tumor 8 Years after Thyroid Surgery: A Case Report
Madara Ratniece1,2, Elina Tauvena2, Sergejs Pavlovics1,2,3
1Radiology Research Laboratory, Riga Stradins University, Riga, Latvia.
Case Reports in Oncology
|July 11, 2022
Summary
This case report details an unusually large parathyroid carcinoma (PC) that mimicked thyroid cancer recurrence. Early diagnosis and surgical removal are crucial for this rare endocrine malignancy.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Parathyroid carcinoma (PC) is a rare endocrine malignancy, accounting for less than 1% of hyperparathyroidism cases.
- Previous neck surgery can complicate the diagnosis of recurrent or new neck masses.
- Accurate diagnosis of PC is challenging due to its rarity and potential to mimic other conditions.
Observation:
- A 63-year-old female with a history of hemithyroidectomy presented with a large neck mass.
- Laboratory tests revealed elevated parathyroid hormone and calcium levels.
- Multiparametric ultrasonography, including contrast-enhanced ultrasound (CEUS), and CT imaging were performed.
- A large tumor (9 x 6 cm) was identified adjacent to major neck structures.
Findings:
- Pathohistological examination confirmed parathyroid carcinoma with capsular penetration and focal necrosis.
- Immunohistochemical analysis showed positivity for chromogranin, CD56, and Ki-67, consistent with PC.
- This is the first reported case of PC where CEUS was utilized.
Implications:
- Parathyroid carcinoma presents a diagnostic challenge, particularly in patients with prior neck surgery.
- Multidisciplinary collaboration is essential for optimal patient management.
- Radical surgery is the only curative treatment, and lifelong monitoring is necessary due to high recurrence rates.
