The Frequency of Synchronous Parathyroid Adenomas and Papillary Thyroid Carcinomas: Clinicopathological Evaluation

Objective: We aimed to evaluate the frequency and clinicopathological features of papillary thyroid carcinomas synchronized with parathyroid adenoma and to compare the “parathyroid adenoma with papillary thyroid carcinoma” and “parathyroid adenoma without papillary thyroid carcinoma” groups. Methods: The study included 287 parathyroid adenoma cases that had concomitant thyroid surgery. Age, gender, parathyroid adenoma characteristics, diagnosis for thyroid materials, and clinicopatho-logical prognostic parameters for papillary thyroid carcinomas were recorded from the pathology reports. Results: Synchronous parathyroid adenoma and thyroid malignancy rate was 27.2%, and papillary thyroid carcinomas were 88.5% of the malignancies. Papillary thyroid carcinomas were mostly seen in female patients and in right thyroid lobe, the multifocality rate was 18.8%, the follicular variant being the most common, the majority were papillary microcarcinomas and pT1 tumors, extrathyroi-dal extension rate was 13%. “Parathyroid adenoma with papillary thyroid carcinoma” and “parathyroid adenoma without papillary thyroid carcinoma” groups were statistically similar in the patient and parathyroid adenoma characteristics. Intrathyroidal parathyroid adenomas and the right parathyroid gland involvement were more common in “parathyroid adenoma with papillary thyroid carcinoma” group, while multiple parathyroid adenomas and left parathyroid gland involvement were more common in “parathyroid adenoma without papillary thyroid carcinoma” group. Inferior parathyroid gland involvement was more common than the superior, and the mean parathyroid adenoma size was similar for both groups. Conclusion: Synchronous parathyroid adenoma and papillary thyroid carcinoma cases are not uncommon, and detection of papillary thyroid carcinoma may change the surgical procedure. Therefore, all parathyroid adenoma cases should be thoroughly investigated for concomitant thyroid pathologies before surgery

Facial cutaneous metastasis of rectal adenocarcinoma

Skin metastasis caused by carcinomas is associated with poor prognosis and is a rare and late clinical finding. Skin metastases occur in only 9-6.5% of Stage IV colorectal cancer. We present an unusual case of Stage IV unresectable rectal adenocarcinoma metastasized to the head and face. One and a half years after diagnosis, new skin lesions developed on his face. Biopsy showed mucinous adenocarcinoma consistent with rectal malignancy. Moreover, he died 3 months after the diagnosis of cutaneous metastasis. This case emphasizes the importance of the effect of skin lesions on prognosis in patients with a history of malignancy