Endocrine Abstracts

The incidence of well differentiated thyroid carcinoma (TC), mostly papillary, is higher among patients with primary hyperparathyroidism (PHPT) compared to the general population, despite the similar frequency of thyroid nodules. The link between TC and Hashimoto thyroiditis (HT) is attributed to chronic inflammation, but the molecular association is poorly undestood. Herein, we explore the possible interplay between HT, PHPT and papillary TC through a case report and a literature review. A 49-year-old female patient underwent right superior parathyroidectomy due to primary hyperparathyroidism and a total thyroidectomy because of a suspicious nodule. Histopathological findings were consisted of concomitant parathyroid adenoma and 2 mm papillary thyroid microcarcinoma with Hürthle cell features whereas the remaining tissue of the thyroid showed a typical pattern of HT. No capsular infiltration was detected neither the pathological lymph nodules. Postoperatively, TSH suppressive therapy was administered. Patient with PHPT should be closely monitored for the thyroid nodule on ultrasound, particularly if they have HT. The need of fine-needle aspiration (FNA) and cytological analysis of the suspected subcentimeter nodules in this setting is still to be clarified. Vice versa, when preparing for thyroidectomy, a serum calcium and parathyroid hormone should be measured. This preoperative screening can be a useful tool for detecting possible concomitant lesions and reducing reoperations and further complications.