A case of normocalcemic primary hyperparathyroidism presenting with a mass in the oral cavity and accompanying incidental papillary thyroid carcinoma

Year 2022, Volume: 47 Issue: 4, 1764 - 1767, 28.12.2022

Emek Topuz , Dilek Tüzün , Ümit Nur Özbay , Murat Şahin , İrfan Kara

https://doi.org/10.17826/cumj.1184876

Abstract

Hyperparathyroidism (HPT) is an endocrine disorder characterized by high secretion of parathyroid hormone. Brown tumor is one of the skeletal manifestations of HPT. Its overall prevalence is low (about 0.1%). Involvement of facial bones is extremely rare. The mandible is involved in 4.5% of cases. Primary HPT (PHPT)with vitamin D deficiency worsens the clinical course. Parathyroid adenoma is detected in ectopic places with a rate of 8.5%. 0.2% is intrathyroidal, 2% is located in different neck regions, 4.1% is in the upper mediastinum, and 2.2% is in the lower mediastinum. The prevalence of papillary thyroid cancer (PTC) in PHPT patients has been reported to range from 2% to 15%. In the literature, incidentally detected papillary thyroid cancer in patients with hyperparathyroidism was detected in patients who underwent total thyroidectomy associated with intrathyroidal parathyroid adenoma.
In this article, we present a case of incidental papillary thyroid carcinoma with ectopic parathyroid adenoma accompanied by severe vitamin D, and diagnosed during accompanying surgery following a brown tumor was considered after primary hyperparathyroidism was detected. However, the patient was admitted with a mass in the oral cavity, diagnosed before as a pyogenic granuloma with a delayed diagnosis without considering brown tumor because it was normocalcemic. It is the first case in the literature of papillary thyroid carcinoma detected incidentally with ectopic parathyroid adenoma in the thyrothymic region.

Keywords

brown tumor, ectopic parathyroid adenoma, normocalcemic hyperparathyroidism, papillary thyroid cancer

Oral kavitede kitle ve eşlik eden insidental papiller tiroid karsinomu ile başvuran normokalsemik primer hiperparatiroidizm olgusu

Abstract

Hiperparatiroidizm (HPT), yüksek paratiroid hormonu salgılanması ile karakterize bir endokrin bozukluktur. Brown tümör, HPT'nin iskelet belirtilerinden biridir. . Genel prevalansı düşüktür (yaklaşık %0,1) .Yüz kemikleri tutulumu son derece nadirdir. Mandibula vakaların %4,5’inde tutulur. D vitamini eksikliği ile birlikte olan Primer HPT (PHPT) klinik gidişi kötüleştirir. Paratroid adenomu %8.5 oranında ektopik yerlerde tespit edilir. %0.2 intratroidial ,%2 si boyunda farklı bölgelerde ve, %4.1 üst mediastende ve %2.2 alt mediastende bulunur. PHPT hastalarında, papiller tiroid kanseri (PTC) prevalansının %2 ila %15 arasında olduğunu bildirmiştir. . Literatürde hiperparatroidili hastalarda insidental olarak saptanan tiroid papiller kanseri intratroidial paratroid adenomu birlikteliğinde total troidektomi yapılan hastalarda saptanmıştır.
Biz bu yazıda, oral kavitede kitle ile başvurmuş, normokalsemik olduğu için önce brown tümör düşünülmeyen bu nedenle tanısı geciken piyojenik granülom tanısı alan , primer hiperparatiroidizm saptandıktan sonra brown tümör düşünülen, ciddi D vitaminin eşlik ettiği ektopik paratiroid adenomu ve buna eşlik eden cerrahi sırasında tanı konan insidental tiroid papiller karsinomu olgusunu sunuyoruz. Tirotimik bölgede ektopik paratiroid adenomu ile birlikte insidental olarak saptanan tiroid papiller karsinomu vakası olarak literatürdeki ilk vakadır.

Keywords

brown tümör, ektopik paratiroid adenomu, normokalsemik hiperparatroidizm, papiller tiroid kanseri

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