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Chatzidakis S, Lamnisos D, Constantinides V, Kyriacou A, Economides A, Economides PA. Impact of autoimmune thyroiditis on primary hyperparathyroidism. JOURNAL OF MEDICAL SCIENCE 2023. [DOI: 10.20883/medical.e737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Aim. Primary hyperparathyroidism (PHPT) often coexists with thyroid diseases. Current guidelines advise preoperative ultrasound (US) examination of the thyroid gland for thyroid nodular disease or concomitant malignancy but not evaluation for autoimmune thyroiditis (AIT). The impact of autoimmune thyroiditis on the clinical presentation and intraoperative course of PHPT is not clear.
Material and methods. We retrospectively assessed the medical records of 21 patients with PHPT who underwent parathyroidectomy. Clinical, biochemical, ultrasonographic and intraoperative data were evaluated.
Results. There was a longer duration of parathyroidectomy in patients with AIT than in those without (113.3 min vs. 93.9 min, P=0.03). A lower rate of kidney stones was noted in patients with autoimmune thyroiditis (44.4% vs. 0%, P=0.03). Patients with AIT were more symptomatic, but this was not significant. There was no difference between the two groups in the prevalence of osteoporosis or thyroid nodular disease.
Conclusions. A significantly longer duration of parathyroidectomy was seen in PHPT patients with AIT. Patients with PHPT undergoing surgery should be investigated for autoimmune thyroiditis, as this may affect surgical planning.
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Outcomes of concurrent parathyroidectomy and thyroidectomy among CESQIP surgeons. Am J Surg 2022; 224:1190-1196. [DOI: 10.1016/j.amjsurg.2022.03.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/26/2022] [Accepted: 03/23/2022] [Indexed: 11/01/2022]
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Efared B, Sani R, Tahiri L, Smahi M, Mazaz K, Ousadden A, Chbani L. Comparative analysis of clinicopathologic features between adenoma and hyperplasia in surgically treated patients for hyperparathyroidism: A retrospective study. Ann Med Surg (Lond) 2021; 71:102929. [PMID: 34691450 PMCID: PMC8517285 DOI: 10.1016/j.amsu.2021.102929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Hyperparathyroidism (HPT) is a common endocrine disorder resulting from overproduction of parathyroid hormone (PTH). Usually HPT is caused by parathyroid adenoma (PA) or parathyroid hyperplasia (PH). Our aim is to assess clinicopathologic features associated with PA and PH in patients with HPT. METHODS We retrospectively collected 29 cases of HPT recorded at the Department of Pathology of Hassan II University Hospital of Fes, Morocco, from 2013 to 2016. RESULTS The mean age was 52.14 ± 15.7 years (range of 22-76 years), 13 patients (44.8%) had primary HPT, 16 (55.2%) had secondary HPT. The largest size of the resected parathyroid specimens ranged from 1 to 3.6 cm (mean of 2.26 ± 0.66 cm). Seventeen patients (58.6%) had PA, the remaining cases were diagnosed as PH. There were no significant statistical differences between PA and PH in age, sex, clinical presentation, preoperative serum PTH, or in parathyroid gland size (P > 0.05). However compared to PH, PA is more often a single-gland disease, found in primary HPT with higher preoperative calcium level (P ˂ 0.05). CONCLUSIONS In patients surgically treated for HPT, PA is associated with some distinctive clinicopathologic features. These findings could be helpful to pathologists and clinicians for appropriate clinicopathologic management.
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Affiliation(s)
- Boubacar Efared
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
- Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger
| | - Rabiou Sani
- Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger
- Department of Thoracic Surgery, Hassan II University Hospital, Fès, Morocco
| | - Layla Tahiri
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
- Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdallah University, Fès, Morocco
| | - Mohamed Smahi
- Department of Thoracic Surgery, Hassan II University Hospital, Fès, Morocco
- Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdallah University, Fès, Morocco
| | - Khalid Mazaz
- Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdallah University, Fès, Morocco
- Department of General and Visceral Surgery, Hassan II University Hospital, Fès, Morocco
| | - Abdelmalek Ousadden
- Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdallah University, Fès, Morocco
- Department of General and Visceral Surgery, Hassan II University Hospital, Fès, Morocco
| | - Laila Chbani
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
- Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdallah University, Fès, Morocco
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Özden S, Saylam B, Daglar G, Yuksek YN, Tez M. ARE THYROID NODULES AN OBSTACLE TO MINIMAL INVASIVE PARATHYROID SURGERY? A SINGLE-CENTER STUDY FROM AN ENDEMIC GOITER REGION. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 15:531-536. [PMID: 32377254 DOI: 10.4183/aeb.2019.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context Minimally invasive parathyroidectomy (MIP) procedure has become a widely accepted alternative to the standard four-gland exploration nowadays. Objective The aim of this study was to evaluate patients with primary hyperparathyroidism (PHPT), who had been treated with thyroidectomy and bilateral neck exploration (BNE), rather than MIP alone, due to coexisting thyroid nodules and to determine the benefits of simultaneous thyroidectomy and the possible negative outcomes of not performing this additional procedure. Design There were 185 patients who were operated for PHPT at our clinic from January 2014 to November 2016. Subjects and Methods 50 patients meet inclusion criteria: have thyroidectomy at the same time of parathyroid surgery, have concordant findings of parathyroid adenoma localization at preoperative MIBI-SPECT and the cervical US and have not had malignancy on fine needle aspiration biopsy (FNAB). Results The mean age of the patients was 55.3±10.4, and female to male ratio was 7:1. All patients had parathyroidectomy with BNE and thyroidectomy: 11 (22%) patients had micropapillary thyroid cancer (mPTC), 2 (4%) had papillary thyroid cancer (PTC). Conclusion The results were inconclusive in clearly demonstrating which patients presenting with coexisted thyroid nodules should undergo thyroidectomy, rather than MIP, and which should be monitored for thyroid nodules after MIP. However, we consider that in cases who are not clearly indicated for thyroidectomy, MIP followed by monitoring of thyroid nodules can be the treatment approach.
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Affiliation(s)
- S Özden
- TC Saglik Bakanligi, Ankara Numune Training and Research Hospital - Surgery, Altindag, Ankara, Turkey
| | - B Saylam
- TC Saglik Bakanligi, Ankara Numune Training and Research Hospital - Surgery, Altindag, Ankara, Turkey
| | - G Daglar
- TC Saglik Bakanligi, Ankara Numune Training and Research Hospital - Surgery, Altindag, Ankara, Turkey
| | - Y N Yuksek
- TC Saglik Bakanligi, Ankara Numune Training and Research Hospital - Surgery, Altindag, Ankara, Turkey
| | - M Tez
- TC Saglik Bakanligi, Ankara Numune Training and Research Hospital - Surgery, Altindag, Ankara, Turkey
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Castellano E, Benso P, Attanasio R, Boriano A, Lauro C, Borretta G, Borghi F. Surgical Approach to Primary Hyperparathyroidism in Patients with Concomitant Thyroid Diseases: A Retrospective Single Center Study. Int J Endocrinol 2020; 2020:2182539. [PMID: 32148486 PMCID: PMC7057020 DOI: 10.1155/2020/2182539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/23/2020] [Accepted: 01/31/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Primary hyperparathyroidism (PHPT) and thyroid diseases are a frequent concomitant occurrence, but the surgical approach to associated disease is still debated. METHODS We retrospectively evaluated a series of PHPT patients focusing on thyroid disease and surgery. RESULTS Among 238 PHPT patients undergoing parathyroidectomy (PTX) between 2002 and 2017, 128 were affected also by a benign thyroid disease, namely, goiter in 118 (76 multinodular (MNG) and 42 uninodular (UNG)), autoimmune thyroiditis in 10, and hyperthyroidism in 21. Surgical approach was unilateral neck exploration (UNE) in 59 patients and bilateral neck exploration (BNE) in 69. The PHPT cure rate was 94%. On comparing patients submitted to PTX only and PTX plus thyroidectomy (TX), in the latter MNG and hyperthyroidism were more frequent, and surgical time and length of stay were longer. No difference in surgical complications was found between patients undergoing UNE and BNE. CONCLUSION PHPT patients with a concomitant thyroid disease underwent double surgery in almost two-thirds of the cases, mostly by BNE. The main factors driving the decision to perform concomitant PTX and TX were the presence of thyroid nodular disease with the nodule site ipsilateral to the presurgically localized parathyroid adenoma.
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Affiliation(s)
- Elena Castellano
- Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy
| | - Paolo Benso
- Unit of General and Oncological Surgery, Department of Surgery, Santa Croce and Carle Hospital, Cuneo, Italy
| | - Roberto Attanasio
- IRCCS Orthopedic Institute Galeazzi, Endocrinology Service, Milan, Italy
| | - Alberto Boriano
- Medical Physics Department, Santa Croce and Carle Hospital, Cuneo, Italy
| | - Corrado Lauro
- Unit of General and Oncological Surgery, Department of Surgery, Santa Croce and Carle Hospital, Cuneo, Italy
| | - Giorgio Borretta
- Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy
| | - Felice Borghi
- Unit of General and Oncological Surgery, Department of Surgery, Santa Croce and Carle Hospital, Cuneo, Italy
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Preda C, Branisteanu D, Armasu I, Danila R, Velicescu C, Ciobanu D, Covic A, Grigorovici A. Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics. BMC Surg 2019; 19:94. [PMID: 31311533 PMCID: PMC6636032 DOI: 10.1186/s12893-019-0556-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported. The aim of the study was to evaluate the rate of thyroid cancer in patients operated for either primary (PHPT) or secondary hyperparathyroidism (SHPT). METHODS Our retrospective study included PHPT and SHPT patients submitted to parathyroidectomy and, when indicated, concomitant thyroid surgery between 2010 and 2017. RESULTS Parathyroidectomy was performed in 217 patients: 140 (64.5%) for PHPT and 77 (35.5%) for SHPT. Concomitant thyroid surgery was performed in 75 patients with PHPT (53.6%), and 19 papillary thyroid carcinomas (PTC) were found, accounting for 13.6% from all cases with PHPT and 25.3% from PHPT cases with concomitant thyroid surgery. Thirty-one of operated SHPT patients (40.3%) also underwent thyroid surgery and 9 PTC cases were diagnosed (11.7% of all SHPT patients and 29% of patients with concomitant thyroid surgery). We found differences between PHPT and SHPT patients (p < 0.001) with respect to age (54.6 ± 13y versus 48.8 ± 12y), female-to-male ratio (8:1 versus ~ 1:1), surgical technique (single gland parathyroidectomy in 82.8% PHPT cases; versus subtotal parathyroidectomy in 85.7% SHPT cases) and presurgical PTH (357.51 ± 38.11 pg/ml versus 1020 ± 161.38 pg/ml). Morphopathological particularities, TNM classification and multifocality incidence of PTC were similar in the two groups. All PTC from patients with SHPT were thyroid microcarcinomas (TMC, i.e. tumors with a diameter smaller than 1 cm), whereas seven out of the 19 cases with PTC and PHPT were larger than 1 cm. CONCLUSIONS PTC was frequently and similarly associated with both PHPT and SHPT irrespective of presurgical PTH levels. Thyroid tumors above 1 cm were found only in patients with PHPT. Investigators should focus also on associated thyroid nodular pathology in patients with PHPT.
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Affiliation(s)
- Cristina Preda
- Faculty of Medicine, Department of Endocrinology, "Gr igore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Dumitru Branisteanu
- Faculty of Medicine, Department of Endocrinology, "Gr igore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania.
| | - Ioana Armasu
- Department of Morphofunctional Sciences, "Grigore T. Popa" University of Medicine, Iasi, Romania
| | - Radu Danila
- Faculty of Medicine, Department of Surgery, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Cristian Velicescu
- Faculty of Medicine, Department of Surgery, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Delia Ciobanu
- Faculty of Medicine, Department of Morphopathology, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
| | - Adrian Covic
- Faculty of Medicine, Department of Nephrology, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania.,Academy of Romanian Scientists, Bucuresti, Romania
| | - Alexandru Grigorovici
- Faculty of Medicine, Department of Surgery, "Grigore T Popa" University of Medicine and Pharmacy, 16 Universitatii Str, 700115, Iasi, Romania
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Latina A, Castellano E, Cesario F, Boriano A, Attanasio R, Borretta G. UNKNOWN AND ALREADY KNOWN THYROID ABNORMALITIES IN PRIMARY HYPERPARATHYROIDISM. Endocr Pract 2019; 24:628-633. [PMID: 30048169 DOI: 10.4158/ep-2018-0016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Primary hyperparathyroidism (PHPT) and thyroid diseases are highly prevalent in the general population, but the putative link between the 2 conditions remains unclear. METHODS A monocentric consecutive series of 434 patients with PHPT was retrospectively evaluated by lab and ultrasonography to look for thyroid abnormalities. Patients were classified in 3 groups: without thyroid abnormalities (group 1, n = 171), with thyroid diseases not previously known (group 2a, n = 69), and thyroid diseases previously known (group 2b, n = 194). RESULTS In terms of thyroid disease, no significant difference was found between groups 2a and 2b, except for the significantly larger number of patients with toxic nodular goiter in group 2b. PHPT was more frequently symptomatic in group 2a than in group 2b, despite no differences in serum calcium, creatinine, parathyroid hormone (PTH), or 25-hydroxyvitamin D (25OHD) levels. CONCLUSION A total of 60% of PHPT patients had a thyroid disease that was unknown prior to PHPT diagnosis in almost one-third of cases. The newly diagnosed and previously known thyroid diseases were similar, both mostly affecting postmenopausal females. ABBREVIATIONS Ab = antibody; aPHPT = asymptomatic PHPT; 25OHD = 25-hydroxyvitamin D; PHPT = primary hyperparathyroidism; PTH = parathyroid hormone; Tg = thyroglobulin; TPO = thyroperoxidase; TSH = thyroid-stimulating hormone; US = ultrasound.
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Ryan S, Courtney D, Moriariu J, Timon C. Surgical management of primary hyperparathyroidism. Eur Arch Otorhinolaryngol 2017; 274:4225-4232. [DOI: 10.1007/s00405-017-4776-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 10/11/2017] [Indexed: 11/25/2022]
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Panarese A, D'Andrea V, Pontone S, Favoriti P, Pironi D, Arcieri S, Filippini A, Sorrenti S. Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study. Aging Clin Exp Res 2017; 29:29-33. [PMID: 27832469 DOI: 10.1007/s40520-016-0665-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/26/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Thyroid disease and hyperparathyroidism are the most common endocrine disorders. The incidence of thyroid disease in patients with hyperparathyroidism ranges in the different series from 17 to 84%, and thyroid cancer occurs with an incidence ranging from 2 to 15%. AIM The aim of our study was to analyze the management of elderly patients with concomitant thyroid and parathyroid disease in order to define the best surgical therapeutic strategy and avoid reoperations associated with a higher risk of complications. METHODS All consecutive patients (64 patients, age range 60-75 years), undergoing surgery for hyperparathyroidism, from January 2011 to June 2014, were retrospectively evaluated. Enrolled patients were divided into two study groups of patients affected by hyperparathyroidism with or without a concomitant thyroid disease. RESULTS Out of 64 patients enrolled in our study (24 men, age range 60-75 years), affected by hyperparathyroidism, 34 had an associated thyroid disease and were treated with total thyroidectomy and parathyroidectomy. The group, who underwent parathyroidectomy associated with thyroidectomy, had no greater complications than the group receiving only parathyroidectomy. CONCLUSIONS Thyroid disease must be excluded in patients affected by hyperparathyroidism. It is difficult to determine whether hyperparathyroidism can be considered a risk factor for thyroid disease, but an accurate preoperative study is essential for a surgery able to treat both thyroid and parathyroid disease. In this way, we avoid the elderly patient, with associated morbidity and increased surgical risk, to undergo a reoperation for thyroid disease, burdened with major complications.
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Affiliation(s)
- Alessandra Panarese
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
| | - Vito D'Andrea
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy
| | - Stefano Pontone
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy
| | - Pasqualino Favoriti
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy
| | - Stefano Arcieri
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy
| | - Angelo Filippini
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy
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Celik M, Guldiken S, Ayturk S, Bulbul BY, Tastekin E, Can N, Sezer A, Ustun F, Kucukarda A. Benign and Malignant Thyroid Gland Diseases in the Patients with Primary Hyperparathyroidism. Int J Appl Basic Med Res 2017; 7:117-120. [PMID: 28584743 PMCID: PMC5441259 DOI: 10.4103/2229-516x.205806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introduction: This study aimed to evaluate concurrently detected thyroid pathologies in the patients who underwent surgery for primary hyperparathyroidism (PHPT). Materials and Methods: In this study, we retrospectively analyzed the files of the patients who underwent surgery for PHPT between 2012 and 2015. Pre- and post-operative laboratory examination results and preoperative radiological and nuclear medicine findings of the patients were retrospectively recorded. Results: A total number of 41 patients with PHPT were divided into two groups as the Group 1 with PHPT and benign thyroid pathology (21 patients) and the Group 2 with PHPT and malignant thyroid pathology (20 patients). In Group 1, 18 and 3 of 21 patients were females and males, respectively. Group 2 included 15 male and 5 female patients. The mean age of the patients was found to be 55.6 and 53.9 years in Group 1 and Group 2, respectively. Both groups were matched for age and gender. In terms of thyroid pathology, 20 of 41 patients (48.7%) who underwent total thyroidectomy for PHPT were found to have thyroid papillary carcinoma while benign pathologic conditions were detected in 21 (51.3%) individuals. Conclusions: Cooccurrence of thyroid diseases and PHPT is common. Therefore, all the patients should preoperatively be evaluated for the presence of thyroid pathology to determine the technique of parathyroid surgery.
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Affiliation(s)
- Mehmet Celik
- Department of Endocrinology and Metabolism, Medical Faculty, Trakya University, Edirne, Turkey
| | - Sibel Guldiken
- Department of Endocrinology and Metabolism, Medical Faculty, Trakya University, Edirne, Turkey
| | - Semra Ayturk
- Department of Endocrinology and Metabolism, Medical Faculty, Trakya University, Edirne, Turkey
| | - Buket Yilmaz Bulbul
- Department of Endocrinology and Metabolism, Medical Faculty, Trakya University, Edirne, Turkey
| | - Ebru Tastekin
- Department of Pathology, Medical Faculty, Trakya University, Edirne, Turkey
| | - Nuray Can
- Department of Pathology, Medical Faculty, Trakya University, Edirne, Turkey
| | - Atakan Sezer
- Department of Surgery, Medical Faculty, Trakya University, Edirne, Turkey
| | - Funda Ustun
- Department of Nuclear Medicine, Medical Faculty, Trakya University, Edirne, Turkey
| | - Ahmet Kucukarda
- Department of Endocrinology and Metabolism, Medical Faculty, Trakya University, Edirne, Turkey
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Surgical treatment of concomitant thyroid and parathyroid disorders: analysis of 4882 cases. Eur Arch Otorhinolaryngol 2016; 274:997-1004. [PMID: 27619822 DOI: 10.1007/s00405-016-4303-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 09/08/2016] [Indexed: 10/21/2022]
Abstract
The thyroid gland disease incidence in hyperparathyroidism (HPT) is higher than the incidence of thyroid disease in general population. Likewise, HPT is more frequent in patients primary admitted due to thyroid disease, than in general population. The aim of this study was to determine the incidence and clinical characteristics of concomitant HPT and thyroid disease, based on a single center experience. From 2009 to 2014, a total of 4882 patients underwent thyroidectomy and/or parathyroidectomy at the Center for Endocrine Surgery, Belgrade. We reviewed the database to find out indications for surgery, clinical characteristics, operative and histopathological findings. Out of 4033 patients, who underwent thyroidectomy, in 114 cases (2.8 %) parathyroidectomy was simultaneously performed. Out of these 114 patients, 42 patients (37 %) had normocalcemic HPT. Among 849 patients primary operated due to HPT, thyroid gland disease that required surgery was found in 224 (26.4 %). In patients primary seen for HPT, thyroid cancer was found in 22 (9.8 %), Hashimoto's thyroiditis in 41 (18.3 %) and micropapillary carcinoma in 36 cases (16.1 %). Due to residual or recidivant HPT, 16 patients (15 who primary underwent parathyroidectomy and 1 primary seen for thyroid disease) needed a reoperation. There are a considerable number of patients with concomitant thyroid and parathyroid disease; this justifies the routine analyses of calcemia and PTH level in patients preparing for thyroidectomy, and sets up the ground for the thyroid investigations in HPT.
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Kiernan CM, Schlegel C, Kavalukas S, Isom C, Peters MF, Solórzano CC. Does concomitant thyroidectomy increase risks of parathyroidectomy? J Surg Res 2016; 203:34-9. [DOI: 10.1016/j.jss.2016.03.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/19/2016] [Accepted: 03/24/2016] [Indexed: 10/22/2022]
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Joliat GR, Demartines N, Portmann L, Boubaker A, Matter M. Successful minimally invasive surgery for primary hyperparathyroidism: influence of preoperative imaging and intraoperative parathyroid hormone levels. Langenbecks Arch Surg 2015; 400:937-44. [DOI: 10.1007/s00423-015-1358-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 11/08/2015] [Indexed: 11/29/2022]
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Affiliation(s)
- Rachel R Kelz
- Division of Endocrine & Oncologic Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 19104, USA.
| | - Douglas L Fraker
- Division of Endocrine & Oncologic Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 19104, USA
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Abstract
Undescended parathyroid adenomas are rare, representing 0.08% of all parathyroid adenomas; however, they make up 7% of the underlying cause of failed cervical exploration in patients with persistent primary hyperparathyroidism. A 43-year-old woman with no significant medical or family history presented with fatigue and was diagnosed with primary hyperparathyroidism; however, preoperative imaging including sestamibi scan and ultrasound was unable to identify the hyperfunctioning gland. She underwent a neck exploration and hemithyroidectomy and partial parathyroidectomy with failure of resolution of her disease. Subsequent work up including a CT of the neck demonstrated a 1.9 cm mass adjacent to the left submandibular gland. This was removed with postoperative normalisation of the patient's serum calcium and parathyroid hormone levels.
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Affiliation(s)
| | - Ali A Maawy
- University of California San Diego, La Jolla, California, USA
| | - Deborah K Oh
- University of California San Diego, La Jolla, California, USA
| | - Michael Bouvet
- University of California San Diego, La Jolla, California, USA
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