The role of ultrasound in the diagnosis of the coexistence of primary hyperparathyroidism and non-medullary thyroid carcinoma

BACKGROUND: The coexistence of primary hyperparathyroidism(PHPT) and papillary thyroid cancer(PTC) is a known entity; it is a rare and complicated setting for diagnostic imaging. METHODS: After reviewing clinical data of 112 patients who had been treated for PHPT in our facility between January 2015 and December 2017, we identified 7 non-medullary thyroid carcinoma (NMTC) (6.25%). All of them had taken an ultrasound scan and undergone operation. In addition, we have also reviewed relevant reports from other facilities addressing PHPT and NMTC (Mainly PTC). RESULTS: The 7 NMTCs were all pathologically confirmed PTC in our study, and they consisted of 6 parathyroid adenomas and 1 parathyroid carcinoma. 1 of the 7 patients had 2 malignant PTC nodules with neck lymph node metastasis, the rest 6 had single-focal PTC. Processing previous report data supported an association between PHPT and PTC, although the coexistence of PHPT and PTC is rare, but it does happen. Ultrasound, as an effective examination, would help screen the simultaneous lesions before operation, thus to avoid second surgery if not observed for both diseases at initial stage. CONCLUSIONS: Ultrasound is a necessary choice for preoperative localization, because it has the ability to simultaneously examine the thyroid and parathyroid lesions.