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EN
Introduction. The prevalence of papillary thyroid carcinoma (PTC) in patients with primary hyperparathyroidism (PHPT) is low, it can be estimated around 2 to 4%. For unknown reasons it is higher than the prevalence of PTC in the overall population. The authors analyse the comorbidity of PTC with PHPT on patients treated in their institution. Material and method. The analysis covered medical records of 885 patients subject to the thyroid resection procedure and 95 patients operated for PHPT, the procedures were performed in years 2005-2014. Results. In the above-mentioned period there were 121 patients operated due to a malignant thyroid tumour and there were 95 patients that had surgery for PHPT. There were 4 cases of comorbidity of PHPT with papillary thyroid cancer. Prevalence of PTC at the patients with PHPT was 4.2%. In two out of the four cases, both diseases were diagnosed prior to the procedure and the single appropriate surgery i.e. total thyroidectomy and excision of parathyroid adenoma was performed. In the other two cases false positive localisation of parathyroid adenoma occurred due to metastatic cancerous lesions in cervical lymph nodes. The diagnosis of PTC was made postoperatively based on surgical specimen examination. Second surgical procedure appropriate for this diagnosis was necessary in both cases. Conclusions. The comorbidity of PHPT and PTC is clinically important and should be taken into account in the case of patients with PHPT and thyroid tumours. There is the possibility of false positive localization of parathyroid adenoma in the case of metastatic cancerous lesions in cervical lymph nodes
PL
Choroby zapalne mięśni są zaliczane do zespołów paranowotworowych. Wśród towarzyszących nowotworów do najczęstszych należą rak jajnika, sutka, płuc, przewodu pokarmowego, nerek, układu krwiotwórczego, czerniak oraz rozpowszechniony w krajach azjatyckich rak nosogardzieli. Mechanizm patogenetyczny odpowiedzialny za współwystępowanie tych chorób nie został dotąd wyjaśniony. Istotną rolę ogrywać może podobieństwo antygenowe pomiędzy regenerującymi się miofiroblastami i niektórymi populacjami komórek nowotworowych. W pracy przedstawiono przypadek zapalenia skórno-mięśniowego u 74-letniego mężczyzny ze współistniejącym guzem pęcherza moczowego i drobnokomórkowym rakiem płuc oraz dwa przypadki zapalenia wielomięśniowego, w tym u 53-letniego mężczyzny, u którego rozpoznano nowotwór jądra i u 63-letniej kobiety, u której w trakcie obserwacji postawiono rozpoznanie guza jajnika oraz zespółu mielodysplastycznego. We wszystkich opisanych przypadkach obserwowano burzliwy początek choroby, w dwóch przypadkach nasilone bóle mięśniowe i zaburzenia połykania, a ponadto brak reakcji na zastosowane leczenie. Powyższe objawy są zaliczane do czynników ryzyka choroby nowotworowej.
EN
Inflmmatory myopathies are classifid as paraneoplastic syndromes. The most common associated are ovary, breast, lung, gastrointestinal and renal – cancers, haematological malignances, melanoma and widely spread in Asian nasopharyngeal carcinoma. Pathogenetic mechanism responsible for the coexistence of these diseases is unknown. Antigenic similarity between the regenerating myofiroblasts and some population of cancer cells may play an important role. We described a case of dermatomyositis in a 74-years old man with concomitant bladder tumor and small-cell lung cancer and two cases of polimyositis: in 53-years old man in whom diagnosed testicular neoplasm and in 63-years old woman in whom ovarian tumor and myelodysplastic syndrome were detected during the observation. In all described cases we observed turbulent onset of disease, in two cases severe muscle pain, diffilty swallowing, and lack of response to therapy. These symptoms are classifid as risk factors for cancer.
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