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Unusual association of diseases/symptoms
CASE REPORT
Concomitant sarcoidosis and papillary thyroid cancer with severe hypercalcaemia as the main symptom
  1. Mikael Groth Riis1,
  2. Kasper Svendsen Juhl1,
  3. Jens Meldgaard Bruun1,2
  1. 1 Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark
  2. 2 Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Professor Jens Meldgaard Bruun, jensbruu{at}rm.dk

Summary

A 65-year-old Caucasian man was admitted to our hospital due to incidental finding of plasma ionised calcium=1.83 mmol/L. During the previous months, he had felt more tired and had experienced an unintended weight loss of 6–8 kg. A CT scan revealed an inhomogeneous thyroid gland and enlarged lymph nodes along the cervical vessels and in the mediastinum. The patient underwent total thyroidectomy and, at the same time, two lymph nodes were removed. Histological examination of the thyroid gland revealed papillary thyroid carcinoma (PTC), T1aN0M0, and histological examination of the lymph nodes showed non-caseating granulomatous inflammation. After further investigation, a diagnosis of sarcoidosis (SA) was made.

Coexistence of SA and PTC may yield a diagnostic challenge as both diseases might involve the lymph nodes of the neck. Furthermore, the case illustrates the importance of close follow-up of even moderate hypercalcaemia, since it may evolve into a hypercalcaemic crisis.

  • thyroid disease
  • endocrine cancer
  • immunology

https://doi.org/10.1136/bcr-2017-222194

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    Footnotes

    • Contributors JMB and MGR were the first to examine the patient and KSJ assisted with the follow-up. MGR, KSJ and JMB developed the idea for a case report. MGR wrote the first draft and all three were involved in the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.