Difficulties in the diagnosis of parathyroid carcinomas due to atypical location with the thyroid gland
F. M. Abdulkhabirova,
E. V. Bondarenko,
M. I. Fadeeva,
K. A. Komshilova,
L. S. Urusova,
E. E. Porubaeva,
A. A. Matrosova,
N. G. Mokrysheva https://doi.org/10.14341/ket12787
Abstract
Parathyroid carcinoma (PC) accounts for 0.005% of all malignant neoplasms and is usually associated with an unfavourable prognosis. The greatest diagnostic difficulties arise from the atypical location of thyroid neoplasms. The prevalence of ectopic location of parathyroid gland (PG) ranges from 2 to 43%, while the incidence of this anomaly in patients with primary hyperparathyroidism is 16-30%. This article analyses the difficulties in diagnosing PC with atypical location of the thyroid gland, using two clinical cases as examples, and suggests additional methods for a personalised approach.
About the Authors
F. M. Abdulkhabirova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Fatima M. Abdulhabirova - MD, PhD.
Moscow
Competing Interests:
None
E. V. Bondarenko
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ekaterina V. Bondarenko - MD, PhD.
11 Dmitriya Ulyanova street, 117292, Moscow
Competing Interests:
None
M. I. Fadeeva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Mariya I. Fadeeva - MD.
Moscow
Competing Interests:
None
K. A. Komshilova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ksenia A. Komshilova - MD, PhD.
Moscow
Competing Interests:
None
L. S. Urusova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Liliya S. Urusova - MD, PhD.
Moscow
Competing Interests:
None
E. E. Porubaeva
Endocrinology Research Centre; Lomonosov Moscow State University
Russian Federation
Competing Interests:
Russian Federation
Erika E. Porubayeva.
Moscow
Competing Interests:
None
A. A. Matrosova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Alina A. Matrosova.
Moscow
Competing Interests:
None
N. G. Mokrysheva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Natalia G. Mokrysheva - MD, PhD, Professor.
Moscow
Competing Interests:
None
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1. Figure 1. Thyroid ultrasonogram. A neoplasm with vague contours of decreased echogenicity, anechogenic areas and calcinates in the capsule is detected in the right lobe of the thyroid. | |
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2. Figure 2: Histograms. Right thyroid lobe neoplasm represented by cells with hyperchromic nuclei, areas of fibrosis, signs of invasion of wide fibrous capsule and vessels; closely adjoining thyroid tissue of micronormofollicular structure with lymphocytic infiltration, formation of few lymphoid follicles with reproduction centers (A). There is diffuse expression of PTH and chromogranin A (Б). TTF-1 expression is absent (В). The index of proliferative activity by ki67 in hot spots is maximized to 3% (Г). | |
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3. Figure 3. Thyroid ultrasonogram. A fluid neoplasm with septa, dense content, clear smooth contours was visualized in the left lobe of the thyroid gland. | |
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4. Figure 4. Histograms. Carcinoma of the parathyroid gland is represented by cells with optically empty cytoplasm, surrounded by irregular fibrous capsule with signs of its invasion and ingrowth into the adjacent fatty tissue, with areas suspicious for vascular invasion; the capsule of the left lobe of the thyroid is “fused” with the tumor due to areas of pronounced fibrosis with foci suspicious for invasion (A). There is diffuse expression of PTH (Б). TTF-1 expression is absent (В). Proliferation activity index by ki67 in hot spots is maximized to 5% (Г). | |
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For citations:
Abdulkhabirova F.M., Bondarenko E.V., Fadeeva M.I., Komshilova K.A., Urusova L.S., Porubaeva E.E., Matrosova A.A., Mokrysheva N.G. Difficulties in the diagnosis of parathyroid carcinomas due to atypical location with the thyroid gland. Clinical and experimental thyroidology. 2024;20(1):41-48. (In Russ.) https://doi.org/10.14341/ket12787
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