Simultaneous medullary and papillary microcarcinoma of thyroid in a patient with secondary hyperparathyroidism.
The simultaneous occurrence of two neoplasms of different cellular origin in one organ is a known but rare event. Such a situation occurs in the thyroid when medullary and follicular carcinoma with differentiation develops. Several cases of transitional tumors have been reported, but the simultaneous occurrence of a carcinoma with medullary and follicular differentiated carcinoma is rare. In all patients, tumors were suspected after local examination of the thyroid. We report on a patient in whom a papillary microcarcinoma was detected on the left side and a medullary carcinoma on the right side while the patient was undergoing surgery for secondary hyperparathyroidism. Both tumors were confirmed by immunohistology; regional lymph nodes were free of tumor. Although the simultaneous occurrence of papillary and medullary carcinoma may have been a simple coincidence, the patient's history offers room for further speculation; he had chronic replicative hepatitis C and a 13-yr history of immunosuppression following renal transplantation. Therefore, a common oncogenic stimulus may have been involved. In the final analysis, the reason for both malignancies could not be clearly established.
Department of Visceral and Transplantion Surgery, Medizinische Hochschule, Hannover, Germany. Behrend@chir.ukl.unifreiburg.de
Matthias
M
Behrand
Reinhard
R
von Wasielewski
Georg
G
Brabant
D002116:Calcitonin / Q000378:metabolism; D018276:Carcinoma, Medullary / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D002291:Carcinoma, Papillary / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology; D007150:Immunohistochemistry; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D013954:Thyroglobulin / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology
D002116:Calcitonin; D013954:Thyroglobulin