Papillary thyroid carcinoma and primary aldosteronism: A new syndrome or a mere association?

Abstract

Primary aldosteronism (PA) is a common disorder, and the condition is underdiagnosed; the prevalence could reach one-third in patients with hypertension, and thyroid carcinoma is the second most common cancer, with papillary thyroid carcinoma (PTC) accounting for 90% of cases. Lymph node metastasis is common in PTC. However, pressure symptoms, including invasion of major local veins and the vagus nerve, are extremely rare. The association between primary hyperaldosteronism and PTC is rare. The interaction between genetic and environmental factors could explain the association. Whether the coexistence of PTC and PA influences the prognosis of PTC is to be explained. The association between PTC and PA with contralateral metastasis, vagus nerve involvement, and invasion to the internal jugular vein is extremely rare. We conducted a comprehensive literature search for relevant articles addressing the possible association of PA and PTC, and we found only 17 cases reported in the literature. The majority were women (10:6 with one study not reporting the gender), the ages ranged from 48 years to 77 years, and perioperative diagnosis was possible in 8 cases. Physicians might need to screen patients with PTC and local invasion for PA.

Keywords: Papillary thyroid carcinoma; Primary aldosteronism; Contralateral metastasis; Vagus nerve; Internal jugular vein; Invasion

Core Tip: Papillary thyroid carcinoma (PTC) and primary aldosteronism are common endocrine disorders. However, their coexistence in the same patient is rare. Local invasion of PTC, including invasion of major local veins and vagus nerve, is extremely rare. This manuscript reviewed the available literature regarding the possible association of PTC and primary aldosteronism and discussed the extremely rare contralateral metastasis and local invasion of PTC to the vagus nerve and internal jugular vein. Our manuscript gave a broader insight into the coexistence of two common endocrine disorders and discussed the risk factors for their association.