Pheochromocytoma, papillary thyroid carcinoma: new entity
Tariq Nasser & Faiza Qari
A 53 year-old woman presented with labile and difficult to control hypertension on three deferent anti hypertensive medications. Abdominal computed tomography (CT) and Ultrasonography of the thyroid gland showed 1.8 cm thyroid nodule. Fine needle aspiration biopsy of the thyroid nodule revealed papillary thyroid carcinoma. Serum TSH & FT4, calcitonin, CEA, intact PTH and calcium levels were within normal limits. A 24-h urine metanephrines showed significant elevation in urine metanephrine of approximately three times the upper limit of normal and the result of 131I-metaiodobenzyleguanjdjne (131I-MIBG) scintgraphy confirmed that the adrenal mass was pheochromocytoma. Right adrenalectomy and total thyroidectomy were performed. The final pathology was pheochromocytoma and papillary thyroid carcinoma. An analysis of RET porto-oncogene mutation yielded negative result. Should this unusual association of tumors represent a new entity.