Intrathyroidal Parathyroid Carcinoma in Chronic Kidney Disease: A Case Report and Review of Literature

Abstract

When parathyroid carcinoma occurs in the thyroid gland, it is very difficult to diagnose beforesurgery because imaging studies and aspiration cytology cannot distinguish parathyroid carcinomafrom thyroid nodule or benign parathyroid disease. A 53-year-old male was referred toour hospital for assessment of hypercalcemia. He had suffered from chronic kidney diseasefor 13 years. A 2.5×1.5 cm hypoechoic nodule was noted in the left thyroid gland on ultrasonography,and it showed increased uptake on the sestamibi scan. Fine needle aspiration biopsyrevealed it to be a parathyroid lesion, which was confirmed by surgery as parathyroid carcinomacompletely surrounded by normal thyroid parenchyme. Because ultrasonography and aspirationcytology have only a limited role in distinguishing parathyroid carcinoma from thyroidneoplasm, suspicion of parathyroid carcinoma before or during surgery through carefulexamination can lead to complete resection at the initial surgery.