Parathyroid Carcinoma Case Report Ihsan Ali Muharom *, Achmad Dimyati ** ** Oncology Surgery Division, Surgery Department, Faculty of Medicine Padjadjaran University / HasanSadikin Hospital, andung ! "esident of Surgery Department, Faculty of MedicinePadjadjaran University / HasanSadikin Hospital, andung ABSTRACT INT RODCTION! Thi s case report is intended to descri"e rare cases, namely parathyroid carc inoma# Par athyr oid tumors are $ery rare, %hen there is usually a carcinoma, appro&imately '#( to () oall parathyroid tumors and is more common in youn+ %omen, most cases are thou+ht to "e a carcinoma turned out other%ise # Accepta"le criteria or mali+nancy is the presence otumor recurrence ater remo$al, distant metastasis or in$as ion oadacent struc tures, adacent metastas is, metastas is to the lun+s, l i$er , "one# CAS- R-PORT! A %oma n, a+ed (( year s, Mrs# -R, present %ith a lump in the nec. that come %ith the ri+ht ront os%allo%in+ mo$ements, the ne%ly perc ei $e d si nce si & mont hs a+o, is not oun d symp toms oin/ltration into surroundin+ or+ans# Since our years a+o, there is a lump in the ri+ht lo%er le+ %hich elt directly "y chic.en e++# 0umps elt are not enlar+ed# Comp laint s acc ompanied "y lethar+y , myal +ia and arthr al+ia and constipation# No symptoms o"ilateral metastasis to re+ional lymph nod es, no dis tant metastases symp toms# T reatment his tory to Or thopaedi cs, suspected tumor metastas is to "one# Then the 12ray e&amination cruris %ith the result s olytic and sclerotic lesions %ere "ersepta and demarcated in the pro&imal third ri+ht ti"ia and a e% small ones seen in the middle third othe ti"ia and /"ula and distal3 Bone prints %ith $isi"le results %hich increased patholo+ical increase oradioacti$ity in "one marro% os pro&imal ti"ia de.stra '45 and '45 medial portion othe let ti"ia os3 and P-T2scan %ith the results appear enlar+ed parathyroid +l and %i th parathyroi d adenoma, ther e"y sho%in+ adanaya pi cture parathyroid aden oma# -ndocrine cons ulted the IPD pati ents , per ormed 6NAB lump in the nec. %i th the results opapill ar y carcinoma a 4 r di7erential dia+nosis othyroid de.stra %ith undi#erentiated8anaplastic9 thyroid carcinoma and papillary thyroid carcinoma %ith epidermoid cyst, then consul ted the Sur+ical Oncolo+y# :is tor y de.stra nephrect omy sur +ery due to inection o.i dne y stones in ';; < at RS:S# 6 rom the physical e&amination ound our e&tremities motor %ea.ness# A 4 r colli ant eri or de.s tra the re are masses %ho par tic ipa ted %i th s%all o%in+ mo$ements, the s.in o$er the same mass %ith the surroundin+ s.in, /rm "oundaries, not 6i&ed, =at surace, hard consistency, si>e '&<,(&<,(cm# A 4 r de.stra cruris '45 pro&imal medial aspect there is mass, the s.in o$er the same mass %ith the surroundin+ s.in, ill de/ned, 6i&ed, =at surace, hard consistency, si>e ?&@&@cm# Do parotide.tomi de.stra, isthmolo" e.tomi de.s tra, ro> en sec tion hist opat holo+ ical e&aminati on de.stra parathyroid and thyroid de.stra# Durante the operation, pole
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Case Report Karsinoma Paratiroid Dr. Ihsan Ali Muharom FK Unpad RSHS
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7/23/2019 Case Report Karsinoma Paratiroid Dr. Ihsan Ali Muharom FK Unpad RSHS
Ihsan Ali Muharom *, Achmad Dimyati **** Oncology Surgery Division, Surgery Department, Faculty of Medicine
Padjadjaran University / HasanSadikin Hospital, andung ! "esident of Surgery Department, Faculty of Medicine
Padjadjaran University / HasanSadikin Hospital, andung
ABSTRACT
INTRODCTION! This case report is intended to descri"e rare cases,namely parathyroid carcinoma# Parathyroid tumors are $ery rare, %henthere is usually a carcinoma, appro&imately '#( to () o all parathyroidtumors and is more common in youn+ %omen, most cases are thou+ht to"e a carcinoma turned out other%ise# Accepta"le criteria or mali+nancy isthe presence o tumor recurrence ater remo$al, distant metastasis orin$asion o adacent structures, adacent metastasis, metastasis to thelun+s, li$er, "one#
CAS- R-PORT! A %oman, a+ed (( years, Mrs#-R, present %ith a lump inthe nec. that come %ith the ri+ht ront o s%allo%in+ mo$ements, thene%ly percei$ed since si& months a+o, is not ound symptoms o in/ltration into surroundin+ or+ans# Since our years a+o, there is a lumpin the ri+ht lo%er le+ %hich elt directly "y chic.en e++# 0umps elt are notenlar+ed# Complaints accompanied "y lethar+y, myal+ia and arthral+iaand constipation# No symptoms o "ilateral metastasis to re+ional lymphnodes, no distant metastases symptoms# Treatment history toOrthopaedics, suspected tumor metastasis to "one# Then the 12raye&amination cruris %ith the results o lytic and sclerotic lesions %ere
"ersepta and demarcated in the pro&imal third ri+ht ti"ia and a e% smallones seen in the middle third o the ti"ia and /"ula and distal3 Bone prints%ith $isi"le results %hich increased patholo+ical increase o radioacti$ityin "one marro% os pro&imal ti"ia de.stra '45 and '45 medial portion o thelet ti"ia os3 and P-T2scan %ith the results appear enlar+ed parathyroid+land %ith parathyroid adenoma, there"y sho%in+ adanaya pictureparathyroid adenoma# -ndocrine consulted the IPD patients, perormed6NAB lump in the nec. %ith the results o papillary carcinoma a 4 rdi7erential dia+nosis o thyroid de.stra %ith undi#erentiated 8anaplastic9thyroid carcinoma and papillary thyroid carcinoma %ith epidermoid cyst,then consulted the Sur+ical Oncolo+y# :istory de.stra nephrectomysur+ery due to inection o .idney stones in ';;< at RS:S# 6rom the
physical e&amination ound our e&tremities motor %ea.ness# A 4 r collianterior de.stra there are masses %ho participated %ith s%allo%in+mo$ements, the s.in o$er the same mass %ith the surroundin+ s.in, /rm"oundaries, not 6i&ed, =at surace, hard consistency, si>e '&<,(&<,(cm# A 4r de.stra cruris '45 pro&imal medial aspect there is mass, the s.in o$erthe same mass %ith the surroundin+ s.in, ill de/ned, 6i&ed, =at surace,hard consistency, si>e ?&@&@cm# Do parotide.tomi de.stra,isthmolo"e.tomi de.stra, ro>en section histopatholo+ical e&aminationde.stra parathyroid and thyroid de.stra# Durante the operation, pole
7/23/2019 Case Report Karsinoma Paratiroid Dr. Ihsan Ali Muharom FK Unpad RSHS
parathyroid tumor mass %as ound under de.stra yello%ish %hite color,encapsulated, %ell de/ned, <#5 cm diameter, attached to the lo%er pole o thyroid de.stra, e&ploration o the let thyroid, parathyroid andparathyroid ri+ht upper pole let no a"normalities# 6rom the ro>en sectionhistopatholo+ical e&amination parathyroid and thyroid de.stra, o"tainedadenomatous +oiter and de.stra parathyroid carcinoma#
ey%ords! parathyroid carcinoma
Parathyroid
Carcinoma
Case Reports
I# ID-NTIT
Name : Mrs. Euis Rohayatoi
Age : 55 years
Address : Kp tile Bandung Barat
Occupation : Housewie
Education : Elementary !chool
"nspection #ate : #ecem$er %&' (&%)
II# :istory
Main *omplaint:
A lump on the right ront nec+
History #isease Now:
!ince , months ago new patients aware o a lump in the nec+ right ront part
mo-es during swallowing o peanuts. re-ious since ) years ago' the patient
complained o a lump in the right lower leg which elt directly $y chic+en egg.
/umps elt are not enlarged. *omplaints with wea+ $ody up can not wal+' aches
$one and muscle throughout the $ody. History *HA0ER noncurrent recogni1ed'
patients admitted BAB once e-ery )25 days.
No other $umps in the nec+ area. No complaints di3cult to swallow' with a
history o cough with -oice $ecomes hoarse. No complaints o shortness o $reath.
History radiation in the nec+ area denied. 4amily history o similar complaints
denied.
Because o the complaint' the patient went to Orthopaedics' said the
possi$ility o tumor metastasis to $one. 0hen lower etremity 62ray eamination'
Correspondent:
Ihsan Ali Muharom, MD.
Surgery Department, Faculty of Medicine Padjadjaran UniversitySUP dr. !asan Sadi"in #l. Pasteur $o. %& 'andung
(mail) ihsanalimuharom*yahoo.co.id
7/23/2019 Case Report Karsinoma Paratiroid Dr. Ihsan Ali Muharom FK Unpad RSHS
monolayer' partly dispersed. Round cell nuclei' coarse chromatin' orming the
core portion pseudoin+lusion structure and little cytoplasm. "t also seems
superCcial suamous cells that spread to the core rather large' polimorC'
chromatin is rather rough.
Conclusions!
apillary *arcinoma a 9 r 0hyroid detra dd 9 undiFerentiated ?anaplastic@
carcinoma' thyroid carcinoma papilary with epidermoid cyst.
=""". -1AMINATION O6 PROPOS-D P-NNHAN
%. *alcium serum
% !erum phosphate
( arathyroid hormone ?0H@
8 0hyroid unction tests
) 0hyroid ultrasound and $ilateral colli
5 0hora hotos
"6. DIANOSIS SPPORT
%. !erum *alcium: 5.77
(. !erum phosphate: no results
8. 0H: no results
). 0hyroid 4unction 0ests
08 > %'7nmol 9 /40) > &'%ng 9 d/
0!Hs > &., "G 9 m/
5. 0hyroid ultrasound and $ilateral colliRight intrathyroid cystic nodules with calciCcation suggesti-e o a parathyroidadenoma dd 9 thyroid nodules' thyroid let this time does not seem +elianan'does not seem lymphadenopathy $ilateral colli
,. 0hora hotos/oo+s intrapulmonary metastasis
7/23/2019 Case Report Karsinoma Paratiroid Dr. Ihsan Ali Muharom FK Unpad RSHS
0hese glands produce parathyroid hormone and calcitonin that play a role inthe meta$olism o calcium and phosphorus. Dlandular secretion is regulated $y the
le-el o calcium in the +idney tu$ules' decreased le-els o parathormone and
calcitonin plasma will lead to heightened rea$sorption o calcium rom $one and
+idney tu$ules' causing an increase in plasma calcium.
7/23/2019 Case Report Karsinoma Paratiroid Dr. Ihsan Ali Muharom FK Unpad RSHS
A situation where the production o primary ele-ated parathormone secretion
increases whereas i the secondary when production increases due to the need.rimary Hyperparathyroid caused a parathyroid adenoma which can lead to a state
o C$rous Osteitis Kisti+a. "n the 62ray picture o thinning $ones appear
accompanied $y the ormation o multiple cysts that' and oten racture patalogis'
which normally occur in the $one plate' pel-is and s+ull. Grinary tract stones are
=ery rarely' when there is usually a carcinoma' approimately %.5 to 5I o all
parathyroid tumors and is more common in young women' most cases are thought
to $e a carcinoma turned out otherwise. Accepta$le criteria or malignancy is the
presence o tumor recurrence ater remo-al' distant metastases or in-asion o ad<acent structures' metastases ad<acent' could metastases to the lungs' li-er'
$one.
7/23/2019 Case Report Karsinoma Paratiroid Dr. Ihsan Ali Muharom FK Unpad RSHS