Coexistence of parathyroid adenoma and papillary thyroid carcinoma

PURPOSE Although several reports have been published regarding the coexistence of hyperparathyroidism and papillary thyroid carcinomas, concurrence of parathyroid adenoma and papillary thyroid carcinoma is extremely rare. The aim of this study was to describe experiences with concurrent parathyroid adenoma and papillary thyroid carcinoma. METHODS Seven patients with concurrent parathyroid adenoma and papillary thyroid carcinoma were identified between January 2006 and December 2007, and their medical records were reviewed retrospectively. RESULTS Of the seven patients identified, three were male and four were female; their mean age was 53.6 years. None of the patients presented with symptomatic hyperparathyroidism preoperatively. On laboratory findings, four patients had mild to moderate hypercalcemia, but serum parathyroid hormone concentrations were high in all patients. Preoperative imaging showed suspicious features of diseased parathyroid glands in four patients; two upon ultrasonography and computed tomography together and two upon ultrasonography only. The coexistence of parathyroid adenoma did not affect the extent of thyroid surgery. Laboratory values after surgery returned to within normal ranges in all patients. CONCLUSION It is important not only to analyze serum calcium levels but also to carefully interpret imaging studies in order to identify asymptomatic hyperparathyroidism when performing thyroid cancer surgery.