Coexistence of primary hyperparathyroidism and differentiated thyroid carcinoma

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 459-496-Thyroid Neoplasia & Case Reports
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-487
Merve Yilmaz1, Arzu Gedik2, Tevfik Demir*1, Ulku Aybuke Tunc3, Ali Sevinc1, Tulay Canda1, Ozhan Ozdogan1, Firat Bayraktar4 and Abdurrahman Comlekci1
1Dokuz Eylul University Medical School, Izmir, Turkey, 2Dokuz Eylul Universitesi Tip Fak, Izmir, Turkey, 3Dokuz Eylul Universitesi, Izmir, Turkey, 4Dokuz Eylul Univ Med Schl, Izmir, Turkey
Introduction: Thyroid cancer has been reported in 2-15 % of patients with hyperparathyroidism (PHPT). It has been speculated that persistent hypercalcemia acting like a goitrogenous agent, may lead to carcinogenesis in these patients. Coexistent medullary thyroid carcinoma and PHPT is a known entity. We herein aimed to outline clinical characteristics of our patients with coexistent PHPT and differentiated thyroid carcinoma (DTC).

Materials and methods: Clinical data of 206 patients which had undergone parathyroidectomy for PHPT were analyzed to detect the patients with coexistent DTC.

Results: DTC was found in 23 (11.2 %) patients (18 females, mean age:55,83±12,07 years). Of those patients, 22 had papillary and one minimally invasive follicular carcinoma (MIFC). The mean values of serum calcium, phosphorus and parathormone (PTH) were 11.2±1.2 mg/dl, 2.7±0.5 mg/dl and 199.4±126.9 pg/ml respectively. The parathyroid pathology of the papillary thyroid cancer (PTC) patients were adenoma (n=19) and hyperplasia (n=3). The patient with MIFC had parathyroid adenoma. There were no significant differences in calcium and PTH levels among the patients with and without DTC.

Conclusion: External radiation to head and neck region has been shown to be a common mechanism of thyroid and parathyroid tumors. The underlying pathogenetic mechanism of the coexistence of PHPT and thyroid cancer is not clear. However, high calcium levels may have oncogenic effects on thyroid gland. Insulin like growth factor and epithelial growth factor have been also shown to be involved in this carcinogenesis.

Disclosure: AC: Consultant, Novartis Pharmaceuticals, Speaker, Novartis Pharmaceuticals, Speaker, Sanofi, Consultant, Sanofi, Speaker, Astra Zeneca, Speaker, Bristol-Myers Squibb, Speaker, Novo Nordisk, Consultant, Novo Nordisk, Speaker, Eli Lilly & Company. Nothing to Disclose: MY, AG, TD, UAT, AS, TC, OO, FB

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