An Unusual Ectopic Location of a Parathyroid Carcinoma Arising within the Thyroid Gland

Introduction: Parathyroid carcinomas are very rare tumors and may arise in the normally located or ectopic gland. The latter present certain diagnostic difficulties, and there are no specific guidelines on their management. We present a case of parathyroid carcinoma arising within an ectopically loc...

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Published in:	The journal of clinical endocrinology and metabolism Vol. 97; no. 6; pp. 1829 - 1833
Main Authors:	Cook, Meghan I, Qureshi, Yassar A, Todd, Colin E. C, Cummins, Richard S
Format:	Journal Article
Language:	English
Published:	Bethesda, MD Endocrine Society 01-06-2012 Copyright by The Endocrine Society
Subjects:	Adult Biological and medical sciences Choristoma - diagnosis Endocrinopathies Feeding. Feeding behavior Fundamental and applied biological sciences. Psychology Humans Male Malignant tumors Medical sciences Parathyroid Glands Parathyroid Neoplasms - diagnostic imaging Parathyroid Neoplasms - surgery Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases) Radionuclide Imaging Technetium Tc 99m Sestamibi Thyroid Diseases - diagnosis Thyroid Diseases - surgery Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Endocrinopathy Obesity Endocrine gland Nutrition Nutrition disorder Metabolic diseases Thyroid gland Malignant tumor Parathyroid carcinoma Parathyroid diseases Ectopia Endocrinology Nutritional status Cancer
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Summary:	Introduction: Parathyroid carcinomas are very rare tumors and may arise in the normally located or ectopic gland. The latter present certain diagnostic difficulties, and there are no specific guidelines on their management. We present a case of parathyroid carcinoma arising within an ectopically located intrathyroid gland and discuss the diagnosis, management, and difficulties encountered. Furthermore, we review all six previously reported cases of this rare event and demonstrate the patterns in presentation, as well as the differences in management. Case Presentation: A 39-yr-old male presented with a right neck mass with biochemical derangement suggestive of a parathyroid lesion. However, radiological investigations were inconclusive as to the true nature of this lesion because they demonstrated a mass within the right thyroid lobe. A sestamibi 99mtechnetium subtraction study was performed, which suggested an intrathyroid parathyroid carcinoma. The patient underwent successful surgical intervention. Conclusion: Although rare, ectopically located parathyroid glands can harbor malignant disease. Those located within the thyroid gland can be difficult to diagnose, and thus a combination of radiological modalities, including sestamibi 99mtechnetium studies, need to be utilized. Although surgical resection is the most effective treatment, there are no specific guidelines as to the radicality of such treatment.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0021-972X 1945-7197
DOI:	10.1210/jc.2011-3115