A CASE OF MULTIPLE PRIMARY PARATHYROID CARCINOMA

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  • 多発性原発性副甲状腺癌の１例

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Abstract

We present a case of multiple parathyroid carcinoma and discuss a possibility of preoperative diagnosis. So far no reports on multiple occurrence of the disease have been seen in the literature and the case might be the first report. In this case, the patient had two tumors, a right and left tumor with the diameter of 21mm and 16mm respectively, which had no infiltration into the surrounding tissue and lymph nodes involvement. So we did not diagnose the tumor as cancer. In terms of the size of these tumors, though, we could guess that the tumor would be cancer. Pathologically, the character of parathyroid carcinoma is that of structural disorder rather than that of cytological one. The right tumor involved the normal thyroid, and partial hemorrhage and coagulation necrosis were found microscopically. We diagnosed the right tumor as cancer. Because of similarities between the two tumors, the left tumor was diagnosed as cancer too. It was unlikely that one tumor metastasized to other tumor. Intraoperatively, we should be careful not to injure the capsule of the tumors. When a tumor is first diagnosed as parathyroid cancer on the histologic study of a permanent preparation after an operation, we are required either to perform operation again or to watch the clinical course strictly. Laparoscopic surgery must be carefully indicated.

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