Papillary thyroid carcinoma associated with non‑functioning parathyroid carcinoma with Warthin's tumor of the parotid gland: A case report and brief literature review.

Ari M Abdullah, Aras J Qaradakhy, Yadgar A Saeed, Abdulwahid M Salih, Seema Karim, Osama A Ali, Shko H Hassan, Shalaw A Nasraldeen, Shvan H Mohammed, Fahmi H Kakamad
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Abstract

Multiple neck pathologies occurring simultaneously are a rare condition. The present study describes an extremely rare case of papillary thyroid carcinoma, non-functioning parathyroid carcinoma (PC) and Warthin's tumor of the parotid gland. A 59-year-old male presented with a 3-month history of anterior neck swelling. The neck ultrasound revealed a left-sided thyroid nodule associated with pathological lymph nodes. There was a parotid gland mass. A fine-needle aspiration of the left parotid mass was not diagnostic, although the left thyroid nodule revealed a malignancy with metastasis to the left cervical group lymph nodes. The patient underwent total thyroidectomy, left central and left lateral cervical lymph node dissection. A superficial parotidectomy was also performed. A histopathological examination revealed three different pathologies: Papillary thyroid microcarcinoma, PC and Warthin's tumor. The simultaneous occurrence of a Warthin's tumor, papillary thyroid microcarcinoma and PC is an unusual condition. The concurrent findings of these three pathologies have not yet been reported in the literature, at least to the best of our knowledge. The synchronous findings of PTC, non-functioning PC and Warthin's tumor are extremely rare, yet possible. Surgical intervention remains the most appropriate treatment strategy.

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甲状腺乳头状癌合并无功能甲状旁腺癌伴腮腺Warthin瘤:1例报告及简要文献复习。
多种颈部病变同时发生是一种罕见的情况。本文报告一例极为罕见的甲状腺乳头状癌、无功能甲状旁腺癌(PC)及腮腺Warthin肿瘤。59岁男性,颈前肿胀3个月。颈部超声示左侧甲状腺结节伴病理淋巴结。有一个腮腺肿块。虽然左侧甲状腺结节显示恶性肿瘤并转移到左侧颈部淋巴结,但左侧腮腺肿块的细针穿刺不能诊断。患者行甲状腺全切除术,左中央和左外侧颈淋巴结清扫术。同时行腮腺浅表切除术。组织病理学检查显示三种不同的病理:乳头状甲状腺微癌,PC和Warthin肿瘤。沃辛氏瘤、甲状腺乳头状微癌和PC同时发生是一种罕见的情况。至少据我们所知,这三种病理的并发发现尚未在文献中报道。PTC、无功能PC和Warthin肿瘤同时出现极为罕见,但也是可能的。手术干预仍然是最合适的治疗策略。
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