A case of double cancer observed in the parathyroid gland and thyroid gland is presented which caused hyperparathyroidism and hypothyroidism.
The patient was a 66-year-old woman admitted to the Department of Dental Radiology, Higashi Nippon Gakuen University Dental Hospital, with the chief complaint of frequently occurred pathological bone fractures. Noteworthy events were not seen either in the family history or in the patient's past history. Physical and laboratory examinations revealed that the symptoms were attributed to hyperparathyroidism.
The panoramic radiograms obtained to detect the osseous changes in the maxillofacial regions showed a cotton-wool appearance in the maxilla and a lace-like appearance in the mandible. The conventional radiograms taken on the first admission to examine the whole body skeleton demonstrated a remarkable cotton-wool appearance in the skull, polycystic lesions in the humeri and femurs, and many other osseous changes in the whole body skeleton.
The spot scan bone scintigrams obtained with
99mTc-MDP showed unusual accumulations in the skull, maxilla, humeri, costae, scapulae, femurs, pelves, thoracic and lumber vertebrae, corresponding to the radiographic findings. The whole body scan bone images displayed many other abnormal accumulations in the whole body skeleton.
The thyroid scintigram obtained with Na
123I revealed an extremely decreased accumulation in the thyroid gland and a well defined ovoid shaped cystic lesion in the left thyroid lobe. The thyroid
123I uptake (24 hours) was 3.4%.
Histological examinations revealed a parathyroid cancer combined with a thyroid cancer.
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