Coexistence of Papillary Thyroid Cancer and Primary Hyperparathyroidism: Report of Five Cases.

Coincidence of primary hyperparathyroidism and thyroid nodules is quite frequent. This is challenging for clinical diagnosis and treatment. We reviewed the records of patients who underwent surgery for primary hyperparathyroidism. Among 52 such cases, thyroidectomy was performed in seven patients (13%) at the same time. Papillary thyroid cancer was detected in five patients (9.6%) as a result of pathologic examination. Two patients were diagnosed with unifocal micro-papillary cancer and these patients underwent unilateral thyroid lobectomy. The remaining three patients, who had thyroid papillary cancer underwent bilateral total thyroidectomy. Likelihood of thyroid cancer should be considered in cases of primary hyperparathyroidism with coexistent thyroid nodules, and a detailed examination should be performed in preoperative period. These will lead to reduce morbidity and lower cost resulting from a second surgery.

Follow-up of granulomatous mastitis with monitoring versus surgery.

BACKGROUND: IGM (Idiopathic Granulomatous Mastitis) is a rare, chronic, non-malignant and non-life-threatening breast disease. Clinically and radiologically, it has similar characteristics with other granulomatous diseases and breast carcinomas. METHODS: The patients whom diagnosed IGM according to pathology report were retrospectively evaluated between November 2014 and January 2016. The demographic properties, complaints during admission, diagnosis and treatment methods and clinical results were obtained via investigation of the patient files. The patients were called for follow-up and discussion. RESULTS: The patients whom diagnosed IGM were retrospectively evaluated and total number of patients were 19. The average following period was 11 months (4-13 months). Fourteen patients were in the reproductive period, five patients were in the postmenopausal period. Ultrasound imaging was performed on all patients, mammography was done on 6 patients over 40 years of age. The patients were not imaged by magnetic resonance imaging (MRI). Sixteen patients had IGM in a single breast, only three patient have an IGM history in bilateral breast, one or three years ago. Core biopsy was performed on all patients. One patient with bilateral IGM diagnosis performed a drainage and incisional biopsy due to a twice developing abscess clinic and recurrence. One patient had final diagnosis coexistence IGM and ductal carcinoma. CONCLUSIONS: Patients who followed-up by observation should be explained that IGM is a chronic disease and that it may recur in certain periods. Clinical, radiological and pathological examinations should be performed together for breast cancer developing due to the chronical progresses of IGM or concurrent breast cancer.

Concomitant thyroid cancer in patients with primary hyperparathyroidism in an endemic goitre region.

OBJECTIVE: Primary hyperparathyroidism (pHPT) is often accompanied by underlying thyroid pathology and 1 to 36% of these thyroid pathologies are malignant. How the identification of these lesions affects patient management is unclear. We present a single-center experience with the prevalence of concomitant thyroid cancer in patients who underwent parathyroidectomy for pHPT. MATERIALS AND METHODS: This was a retrospective cohort study. Two hundred-two patients with primary hyperparathyroidism included study. Demographic data, clinical findings, and final histopathological diagnosis were recorded retrospectively. RESULTS: Preoperative cervical ultrasound examination revealed co-existent thyroid abnormalities in 117 (57.9%) patients. Mean age of these patients was 57.8 ± 12.2 years and 88% were female. Sixty-three (53.9%) of the patients with thyroid abnormalities, underwent preoperative fine needle aspiration biopsy (FNAB). Cytology result was malignant in one (1.6%) patient, benign in 47(85.7%) patients, indeterminate in six (9.5%) patients and Hurthle cell neoplasm in two (3.2%) patients. Ninety-four (80.3%) of the patients underwent simultaneous thyroid surgery. Final pathology of the thyroid specimen was malignant in 26 (12.9%) patients. Sixteen of the malignant patients had preoperative FNAB. Preoperative FNAB result of these patients was malignant in one patient, indeterminate in two patients and benign in 13 patients. CONCLUSION: By implementing a comprehensive approach to patients with pHPT who present with thyroid disease, concomitant pathology may be elucidated preoperatively. But, this approach will not facilitate the detection of otherwise unsuspected thyroid cancer in an endemic goitre region. KEY WORDS: Cancer, Parathyroid adenoma, Parathyroidectomy, Thyroid, Thyroidectomy.