Summary
An acidophilic pituitary adenoma associated with primary nodular parathyroid hyperplasia and a small papillary thyroid carcinoma was discovered at the autopsy of a 44 year old female acromegalic. The thyroid carcinoma showed evidence of lymphatic spread. Several etiopathogenetic mechanisms for the non-medullary thyroid carcinomata associated with Multiple Endocrine Neoplasia (MEN) have been postulated, since the follicular epithelium of the thyroid does not belong to the neural ectoderm derivates unlike the C-cells of the thyroid, the adenohypophysis and probably the parathyroid glands. Apart from genetic influence, or coincidence, one has to rule out carcinogenic exposure or hormonal influence. Clinically speaking, one should always consider whether malignant thyroid disease coexists with hyperplastic or neoplastic parathyroid tissue.
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References
Altenähr, E., Kampf, E.: Parathyroid function in rats treated with growth hormone. Virchows Arch. A Path. Anat. and Histol.371, 363–371 (1976)
André, P.: Postirradiation thyroid cancers. In: Tumors of the thyroid gland, (Appaix, A., Ed.), pp. 299–313. Basel, New York: Karger 1966
Ballard, H.S., Frame, B., Hartsock, R.J.: Familial multiple endocrine adenoma-peptic ulcer complex. Medicine43, 481–516 (1964)
Bartley, P.C., Lloyd, H.M., Aitken, R.E.: Medullary carcinoma of the thyroid, multiple pheochromocytomas, mucosal neuromas, marfanoid habitus and other abnormalities (Sipple's syndrome). Med. J. Aust.2, 173–176 (1976)
Catalona, W.J., Engelman, K., Ketcham, A.S., Hammond, W.G.: Familial medullary thyroid carcinoma, pheochromocytoma, and parathroid adenoma (Sipple's syndrome). Cancer28, 1245–1254 (1971)
Champault, G., Chapuis, Y., Patel, J.C., Louvel, A., Ghozian, R., Cachin, M., Leger, L.: Syndrome de Zollinger-Ellison et adénome parathyroidien. J. Chir. (Paris)112, 131–144 (1976)
Chandola, A., Thapliyal, J.P.: Effect of growth hormone and prolactin on the body weight and thyroid activity of spotted munia. Ann. d'Endocrinologie (Paris)33, 583–591 (1972)
Creutzig, H., Hundeshagen, H.: Schilddrüsenkarzinom nach Radiojodtherapie. Med. Klin.72, 855–857 (1977)
Croisier, J.C., Azerad, E., Lubetzki, J.: L'adénomatose polyendocrinienne (Syndrome de Wermer). Sem. Hôp. Paris47, 494–525 (1971)
Cuello, C., Correa, P., Eisenberg, H.: Geographic pathology of thyroid carcinoma. Cancer23, 230–239 (1969)
Cushing, H., Davidoff, L.M.: Studies in acromegaly. Arch. Intern. Med.39, 673–697 (1927)
Cushman, P.: Familial endocrine tumors. Report of two unrelated kindreds affected with pheochromocytomas, one also with multiple thyroid carcinomas. Am. J. Med.32, 352–360 (1962)
Davies, A.C.: The thyroid gland in cases of acromegaly. J. Clin. Endocrinol. Metab.1, 445–449 (1941)
Daughaday, W.H.: The adenohypophysis. In: Textbook of Endocrinology. Williams, R.H., Ed., pp. 31–79, Philadelphia, London, Toronto: Saunders 1974
DeGroot, L.J.: Thyroid carcinoma. Med. Clin. N.A.59, 1233–1246 (1975)
Ellenberg, A.H., Goldman, L., Gordan, G.S., Lindsay, St.: Thyroid carcinoma in patients with hyperparathyroidism. Surg.51, 708–717 (1962)
Erdheim, J.: Zur normalen und pathologischen Histologie der Glandula thyreoidea, parathyreoidea und Hypophysis. Beitr. pathol. Anat. allg. Pathol.33, 158–236 (1903)
Favus, M.J., Schneider, A.B., Stachura, M.E., Arnold, J.E., Ryo, U.Y., Pinsky, St.M., Colmann, M., Arnold, M.J., Frohman, L.A.: Thyroid cancer occurring as a late consequence of head- and neck irradiation. Evaluation of 1056 patients. New Engl. J. Med.294, 1019–1025 (1976)
Franssila, K.O.: Is the differentiation between papillary and follicular thyroid carcinoma valid? Cancer32, 853–864 (1973)
Fukunaga, F.H., Yatani, R.: Geographic pathology of occult thyroid carcinomas. Cancer36, 1095–1099 (1975)
Gordon, D.A., Hill, F.M., Ezrin, C.: Acromegaly: a review of 100 cases. Canad. Med. Ass. J.87, 1106–1109 (1962)
Gorlin, R.J., Vickers, R.A.: Multiple mucosal neuromas, phaeochromocytoma, medullary carcinoma of the thyroid and marfanoid body build with muscle wasting: reexanimation of a syndrome of neural crest malmigration. Birth Defects7, 69–71 (1971)
Hajjar, E.T., Salti, I.S.: The co-existence of parathyroid and thyroid disease. I. Primary hyperparathyroidism and thyroid carcinoma. Leb. Med. J.26, 241–245 (1973)
Hakama, M.: Different world thyroid cancer rates. In: Thyroid cancer. UICC Monograph Series, Vol. 12. Hedinger, Ch.E., Ed. pp. 66–71, Berlin, Heidelberg, New York: Springer 1969
Hamwi, G.J., Skillman, Th.G., Tufts, K.C.: Acromegaly. Am. J. Med.29, 690–699 (1960)
Harrison, T.S., Thompson, N.W.: Multiple endocrine adenomatosis I and II. Curr. problems in surgery. Chicago: The University of Chicago Press 1975
Heimann, P., Nilsson, O., Hansson, G.: Parathyroid and thyroid disease. II. Thyroid disease connected with hyperparathyroidism. Acta Chir. Scand.135, 143–146 (1970)
Heinze, H.G., Pichlmaier, H.: Diagnostik und Therapie der Struma maligna. Internist13, 148–159 (1972)
Hempelmann, L.H.: Radiation exposure and thyroid cancer in man. In: Thyroid cancer. UICC Monograph Series, Vol. 12. (Hedinger, Ch.E., Ed.) Berlin, Heidelberg, New York: Springer 1969
Ingbar, S.H., Woeber, K.A.: The thyroid gland. In: Textbook of Endocrinology. (Williams, R.H., Ed.), pp. 95–233. Philadelphia, London, Toronto: Saunders 1974
Kairaluoma, M.I., Heikkinen, E., Mokka, R., Huttunen, R., Larmi, T.K.I.: Non-medullary thyroid carcinoma in patients with parathyroid adenoma. Acta Chir. Scand.142, 447–449 (1976)
Kaplan, L., Katz, A.D., Ben-Isaac, C., Massry, Sh.G.: Malignant neoplasms and parathyroid adenoma. Cancer28, 401–407 (1971)
Keiser, H.R., Beaven, M.A., Doppman, J., Wells, S., Buja, L.M.: Sipple's syndrome: medullary thyroid carcinoma, phaeochromocytoma, and parathyroid disease. Ann. Intern. Med.78, 561–579 (1973)
Kind, H.P.: Die Häufigkeit der Struma maligna im Sektions- und Operationsgut des Pathologischen Instituts der Universität Zürich von 1900 bis Mitte 1964. Schweiz. Med. Wschr.96, 560–568 (1966)
Kracht, J., Altenähr, E.: Peripheres, disseminiertes endokrines Zellsystem (APUD-System) und Schilddrüse. Deutsch. Med. Wschr.102, 1196–1200 (1977)
Krementz, E.T., Yeager, R., Hawley, W., Weichert, R.: The first 100 cases of parathyroid tumors from Charity Hospital of Louisiana. Ann. Surg.173, 872–883 (1971)
Laing, V.O., Frame, B., Block, M.A.: Associated primary hyperparathyroidism and thyroid lesions. Arch. Surg.98, 709–712 (1969)
Lancer, St. R., Bowser, E.N., Hargis, G.K., Williams, G.A.: The effects of growth hormone on parathyroid function in rats. Endocrinol.98, 1289–1293 (1976)
Lietz, H.: Pathologische Anatomie der Schilddrüsentumoren. In: Schilddrüse 1973 (Schleusener, H., Weinheimer, B., eds.) pp. 60–69, Stuttgart: Thieme 1974
Lindsay, St., Nichols, C.W., Chaikoff, I.L.: Induction of benign and malignant thyroid neoplasma in the rat. Arch. Path.81, 308–316 (1966)
LiVolsi, V.A., Feind, C.R.: Parathyroid adenoma and nonmedullary thyroid carcinoma. Cancer38, 1391–1393 (1976)
Malette, L.E., Bilezikian, J.P., Heath, D.A., Aurbach, G.D.: Primary hyperparathyroidism: clinical and biochemical features. Medicine53, 127–146 (1974)
Matovinovic, J., Leahy, M.S., Armstrong, W.F., Hill, H.C.: The effect of environment on the growth and function of rat thyroid transplant tumors. In: Thyroid neoplasia. (Young, St., Inman, D.R., eds.) pp. 211–248, London, New York: (1968)
Melicow, M.M.: One hundred cases of pheochromocytoma at the Columbia — Presbyterian Medical Center, 1926–1976. Cancer40, 1987–2004 (1977)
Money, W.L., Rawson, R.W.: Factors influencing malignancy versus benignancy of thyroid neoplasms in man and experimental animals II — experimental animals. In: Thyroid neoplasia. (Young, St., Inman, D.R., eds.), pp. 179–199, London, New York: 1968
Moon, H.D., Simpson, M.E., Li Ch.H., Evans, H.M.: Neoplasms in rats treated with pituitary growth hormone. Cancer Res.10, 364–370 (1950)
Moon, H.D., Simpson, M.E., Li Ch.H., Evans, H.M.: Neoplasms in rats treated with pituitary growth hormone. I. Pulmonary and lymphatic tissue. Cancer Res.10, 297–308 (1950)
Mortensen, J.D., Woolner, L.B., Bennett, W.A.: Gross and microscopic findings in clinically normal thyroid glands. J. Clin. Endocrinol. Metab.15, 1270–1280 (1955)
Mukhtar, E.D., Alexander, L., Wilkinson, R., Appleton, D., Hall, R.: Thyroid function in acromegaly. Lancet2, 279–283 (1971)
Nemec, J., Soumar, J., Zamrezil, V., Pohunkova, D., Motlik, K., Mirejovsky, P.: Familial occurrence of differentiated (non-medullary) thyroid cancer. Oncology32, 151–157 (1975)
Neracher, H., Hedinger, Ch.: Klassifizierung der Schilddrüsenmalignome nach der Nomenklatur der WHO 1974. Schweiz. Med. Wschr.105, 1000–1006 and 1052–1056 (1975)
Ogburn, P.L., Black, B.M.: Primary hyperparathyroidism and papillary adenocarcinoma of the thyroid: report of four cases. Proc. Staff Meet. Mayo Clin.31, 295–298 (1956)
Pearse, A.G.E.: The diffuse endocrine (paracrine) systeme: Feyrter's concept and its modern history. Verh. dtsch. Ges. Path.61, 2–6 (1977)
Pearse, A.G.E., Takor, T.T.: Neuroendocrine embryology and the APUD concept. Clin. Endocrinol.5 Suppl., 229s-244s (1976)
Petro, A.B., Hardy, J.D.: The association of parathyroid adenoma and non-medullary carcinoma of the thyroid. Ann. Surg.181, 118–119 (1975)
Ries, P.: Eine Kasuistik zum Wermer-Syndrom. Polyadenomatose des Endokriniums. Verh. dtsch. Ges. Path.58, 569 (1974)
Robertson, D.M., Sizemore, G.W.: Thickened corneal nerves as a manifestation of multiple endocrine neoplasia. Trans. Am. Acad. Ophtalmol. Otolaryngol.79, OP 772–787 (1975)
Saeger, W.: Die Hypophysentumoren. Stuttgart, New York: Fischer, 1977
Schimke, R.N.: Multiple endocrine adenomatosis syndromes. Adv. Intern. Med.21, 249–265 (1976)
Schneider, A.B., Favus, M.J., Stachura, M.E., Arnold, J., Arnold, M.J., Frohman, L.A.: Incidence, prevalence and characteristics of radiation-induced thyroid tumors. Am. J. Med.64, 243–252 (1978)
Siebenmann, R.E., Steiner, H., Uehlinger, E.: Die pathologische Morphologie der endokrinen Regulationsstörungen. In: Handbuch der allgemeinen Pathologie. Endokrine Regulationsstörungen. (Altmann, H.W., Ed.), Vol. 8. Berlin, Heidelberg, New York: Springer 1971
Sipple, J.H.: The association of phaeochromocytoma with carcinoma of the thyroid. Am. J. Med.31, 163–166 (1961)
Spitalnik, P.F., Strauss II, F.H.: Patterns of human thyroid parenchymal reaction following low-dose childhood irradiation. Cancer41, 1098–1105 (1978)
Steiner, A.L., Goorman, A.D., Powers, S.R.: Study of a kindred with phaeochromocytoma, medullary thyroid carcinoma, hyperparathyroidism and Cushing's disease: multiple endocrine neoplasia, Type 2. Medicine47, 371–409 (1968)
Thomas, C., Bollmann, R., Christov, K.: Pathogenese und Morphologie der Schilddrüsentumoren bei der Ratte. In: Handbuch der allgemeinen Pathologie. (Altmann, H.W., Ed.), Vol. 6, pp. 769–837. Berlin, Heidelberg, New York: Springer 1975
Trout, H.H., Mulder, D.G.: Surgery for parathyroid adenoma. Arch. Surg.105, 67–70 (1972)
Uehlinger, M.: Primärer Hyperparathyreoidismus und papilläres Schilddrüsencarcinom. Schweiz. Med. Wschr.105, 1547–1552 (1975)
Underdahl, L.O., Woolner, L.B., Black, B.M.: Multiple endocrine adenomas: report of 8 cases in which the parathyroids, pituitary and pancreatic islets were involved. J. Clin. Endocrinol. Metab.13, 20–47 (1953)
Weichert, R.F.: The neural ectodermal origin of the peptide-secreting endocrine glands. Am. J. Med.49, 232–241 (1970)
Welbourne, R.B.: Current status of the apudomas. Ann. Surg.185, 1–12 (1977)
Wermer, P.: Genetic aspects of adenomatosis of endocrine glands. Am. J. Med.16, 363–371 (1954)
Wermer, P.: Endocrine adenomatosis and peptic ulcer in a large kindred. Am. J. Med.35, 205–212 (1963)
Woolner, L.B., Beahrs, O.H., Black, B.M., McConahey, W.M., Keating, F.R.: Classification and prognosis of thyroid carcinoma. Am. J. Surg.102, 354–387 (1961)
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Dralle, H., Altenähr, E. Pituitary adenoma, primary parathyroid hyperplasia and papillary (non-medullary) thyroid carcinoma. Virchows Arch. A Path. Anat. and Histol. 381, 179–187 (1979). https://doi.org/10.1007/BF01257883
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DOI: https://doi.org/10.1007/BF01257883