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.
Behrand
Matthias
M
Department of Visceral and Transplantion Surgery, Medizinische Hochschule, Hannover, Germany. Behrend@chir.ukl.unifreiburg.de
von Wasielewski
Reinhard
R
Brabant
Georg
G
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