Hypercalcemia in the patients with malignant tumor has been known as malignancy associated hypercalcemia (MAH). Incidence and pathogenesis of MAH in thyroid cancer was clinically studied in 127 ...patients who died of thyroid cancer, including 71 patients with anaplastic carcinoma, 44 with papillary carcinoma and 12 with follicular carcinoma. Hypercalcemia with more than 11.0mg/dl of serum calcium was found in 8 (6.3%) out of the total 127 cases or 5 (7.0%) out of 71 cases of anaplastic carcinoma On the basis of the mechanisms, MAH was divided into humoral hypercalcemia of malignancy (HHA) and local osteolytic hypercalcemia (LOH). Of the 8 cases of thyroid cancer with MAH, 3 cases without bone metastasis and 3 cases with few bone metastasis, including one case demonstrated an elevation (11.0 pmol/1(<2)) in parathyroid hormone-related protein (PTHrP), were considered to be accompanied with HHM. The other 2 cases with remarkable bone metastasis might be associated with LOH. A fact that the association of hypercalcemia as well as leukocytosis was found in 4.2% of all anaplastic carcinomas may suggest that the tumors in these cases might produce several humoral factors.
It is known that primary hyperparathyroidism is sometimes associated with a thyroid carcinoma other than medullary carcinomas. In this paper a case of papillary carcinoma of the thyroid associated ...with primary hyperparathyroidism is described together with a review of the literature in the light of the correlations between both diseases. A 53-year-old woman complaining of lumbago was suspected of hyperparathyroidism from blood ecamination, and visited our department. Tumors on the right and left sides of the neck were palpated. Echography of the neck revealed a cystic tumor with inner solid section at the tail-side of right lobe of the thyroid, and an echo-poor region with irregular margin in the upper left lobe of the thyroid. Needle biopsy cytology of the tumor on the right-side of the neck resulted in class I, PTH value of the aspirated liquid being abnormally high. While the biopsy cytology of the left tumor showed class V, and it was a papillary carcinoma of the thyroid. From the above, the patient was diagnosed as having a papillary carcinoma of the thyroid associating with primary hyperparathyroidism, and operated on. After surgery blood PTH value was satisfactorily normalized without any severe complications, and the patient was discharged.
A 48-year-old man complaining of cough and hemosialemesis was diagnosed to have an endotracheal metastatic lesion from giant mediastinal tumor by minute exploration. Immediately, radiation therapy ...was started but failed in diminishing the tumor size. The patient developed multimetastasis in the lung and died 2 months later. Autopsy revealed a thyroid tumor and mediastinal tumor continuing to the thyroid one. Histopathologically, the thyroid tumor was papillary carcinoma versus the mediastinal tumor, involving undifferentiated carcinoma in the majority and partially, papillary, adenosquamous cell, and mucoepidermoid carcinomas concomitantly. The part of papillary carcinoma in the mediastinal tumor was thyroglobulin stain-positive, in that it can be considered in this case that thyroid papillary carcinoma transformed into squamous cell, mucoepidermoid, and undifferentiated carcinomas.
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