Concomitant thyroid disease and primary hyperparathyroidism in patients undergoing parathyroidectomy or thyroidectomy

Abstract

Background: Thyroid abnormalities have been found intraoperatively during parathyroidectomy and have resulted in concomitant thyroidectomy. The identification of concomitant disease is important prior to primary operation in order to minimize reoperations. This study investigates the incidence of concomitant primary hyperparathyroidism (PHPT) and thyroid nodular disease in patients undergoing thyroidectomy or parathyroidectomy.Methods: We performed a retrospective review of prospectively gathered data for 621 patients who underwent thyroidectomy, parathyroidectomy, or both at Tulane Medical Center. Information obtained included initial referral, initial thyroid stimulating hormone (TSH), initial parathyroid hormone (PTH), fine needle aspiration (FNA) results, ultrasound results, type of operation performed, final diagnosis, and final pathology.Results: Among the 400 patients referred primarily for thyroid disease, 13.50% underwent a thyroidectomy and parathyroidectomy (PTX) simultaneously and 10.75% received a final diagnosis of thyroid and concomitant parathyroid disease. Among the 103 patients referred primarily for parathyroid disease, 26.21% underwent a PTX and thyroidectomy and 24.27% received a final diagnosis of both thyroid and parathyroid disease. Patients referred primarily for parathyroid disease were more likely to receive a final diagnosis of both parathyroid and thyroid disease and were more likely to undergo a combined operation.Conclusions: Concomitant thyroid and parathyroid disease occur and preoperative analysis is important to avoid increased complications from reoperations.

Association of Hyperparathyroidism and Papillary Thyroid Cancer: A Multicenter Retrospective Study

“…The presence of concomitant PTC can change the evaluation and surgical management of patients with hyperparathyroidism (HPT). In the coexistence of these two diseases, thyroid PTC must be identified prior to surgical management to minimize complications from additional surgical procedures, patient discomfort, and costs [ 12 ].…”

Synchronous papillary thyroid carcinoma and primary hyperparathyroidism: a rare association

“…These incidental nodules are malignant in 5% of these patients. Any suspicious looking thyroid nodule should be evaluated with fine needle aspiration (FNA) [10] which has high sensitivity (94%) and specificity (98%) for the diagnosis of malignant thyroid nodules [4]. Moreover, the 99mTc-MIBI scan is considered as a localization tool with the best sensitivity for the detection of eutopic and even ectopic parathyroid glands [11].…”

“…Although the probability of concomitant thyroid cancer is low, screening for thyroid lesions in patients with primary hyperparathyroidism is recommended. The identification of concomitant disease is important prior to primary operation in order to minimize surgical complications, patient discomfort, and costs [4]. Herein we report three cases of primary hyperparathyroidism associated with synchronous papillary thyroid carcinoma.…”

Primary hyperparathyroidism and non-medullary thyroid cancer- A review

“…On the other hand, thyroid disease is becoming increasingly more frequently diagnosed after the wide spread use of ultrasound, with occult thyroid nodules being prevalent in up to 68% of the general population [7,8]. It is also found incidentally on diagnostic imaging done for purposes not related to thyroid, such as computed tomography (CT scan) or magnetic resonance imaging (MRI) and fluorodeoxy-glucose (FDG)-positron emission tomography (PET) [8].…”

“…It is also found incidentally on diagnostic imaging done for purposes not related to thyroid, such as computed tomography (CT scan) or magnetic resonance imaging (MRI) and fluorodeoxy-glucose (FDG)-positron emission tomography (PET) [8]. Around 10% of patients presenting with thyroid nodules are at risk for malignancy, the most common being differentiated thyroid cancer (DTC), with papillary thyroid cancer (PTC) accounting for around 95% of cases [7,8].…”