Incidental Finding of Papillary Thyroid Carcinoma in the Patients with Primary Hyperparathyroidism

Yazici, Pınar; Mihmanlı, Mehmet; Bozdağ, Emre; Aygün, Nurcihan; Uludağ, Mehmet

doi:10.5152/eurasianjmed.2015.119

Cited by 15 publications

(10 citation statements)

References 21 publications

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“…The incidence of carcinomas in the cervicomediastinal goiter compared with benign thyroid cervical-mediastinum disease, is around 12.1% (50,51). The association with parathyroid diseases (52)(53)(54)(55)(56) and lymphocytic thyroiditis (57, 58) is also described.…”

Section: Discussionmentioning

confidence: 98%

Incidental thyroid carcinomas. A retrospective study

Maturo¹

2017

GCHIR

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Section: Discussionmentioning

confidence: 98%

Incidental thyroid carcinomas. A retrospective study

Maturo¹

2017

GCHIR

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“…Concomitant pHPT and thyroid malignancy have been reported in several studies since the first cases were reported by Ogburn and Black [ 7 ] in 1956. In pHPT patients, several studies reported the prevalence of papillary thyroid cancer (PTC) to range from 2% to 15% [ 8 , 9 ]. Data on the association between sHPT and PTC is more limited.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background: Concomitant papillary thyroid cancer (PTC) and hyperparathyroidism (HPT) have been reported in several studies. Our study aimed to investigate the incidence of concomitant PTC in HPT patients upon preoperative diagnosis and present a clinical opinion on detecting thyroid malignancy in case of parathyroidectomy.Methods: Patients who underwent parathyroidectomy between January 2009 and December 2019 in two medical centers were included. Of the 279 participants 154 were diagnosed as primary hyperparathyroidism (pHPT) and 125 as secondary hyperparathyroidism (sHPT). The incidence of concomitant PTC and its clinical characteristics were compared with 98 patients who underwent thyroidectomy and were diagnosed with classical PTC during the same period.Results: Concurrent PTC was detected in 14 patients (9.1%) with pHPT and in nine patients (7.2%) with sHPT. Ten (71.4%) and seven (77.8%) PTCs were microcarcinomas in the pHPT and sHPT cases respectively. In the pHPT patients, vitamin D was lower in the pHPT+PTC group (13.0±3.7 ng/mL) than in the pHPT-only group (18.5±10.4 ng/mL; P=0.01). Vitamin D levels were also lower in the sHPT+PTC group (12.3±5.6 ng/mL) than in the sHPT-only group (18.0±10.2 ng/mL; P=0.12). In the concomitant PTC group, lymph node ratio was higher than in the classical PTC group (P=0.00).Conclusion: A high prevalence of concomitant PTC was seen in patients with pHPT and sHPT. Those concomitant PTCs were mostly microcarcinomas and had more aggressive features, suggesting that efforts should be made to detect concomitant malignancies in the preoperative parathyroidectomy evaluation.

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“…The malignancy rate of thyroid nodules in PHPT appears to be similar [13,16,18,20] or even higher [3,21] than that in general patients (5-15%) [22], and while some authors found this association to be coincidental [23], others consider PHPT patients with thyroid nodules "extra suspicious" for thyroid malignancies [24]. The latter was shown in 4 cases of PHPT with sub-centimetric thyroid nodules, benign on fine needle aspirate, that were found to be micropapillary carcinoma intra-operatively by frozen section, leading to an extensive surgery and radio-active iodine therapy [24].…”

Section: Differentiated Thyroid Cancer Incidence In Phptmentioning

confidence: 83%

Primary hyperparathyroidism and non-medullary thyroid cancer- A review

El-Boueiz

Salti

2018

int arch med

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Background: The association of thyroid disease and primary hyperparathyroidism is well described, with thyroid carcinoma being reported in 2-15% of cases. The most commonly associated carcinoma is non-medullary thyroid cancer. While the association of PHPT and medullary thyroid cancer (MCT) is well known, that of NMTC, despite its increasing incidence, is still not established. Our study is a review of incidence and underlying mechanisms of non-medullary thyroid cancer associated with PHPT. Also, best imaging tools for concomitant diagnosis is reviewed to ensure an adequate plan of care. Methods & findings: A search was done using two databases: Medline & Embase. The search conducted from the period of 2008 until April 2018 yielded a total of 142 studies. After an adequate screening, 26 studies were reviewed. Incidence of DTC in association with PHPT in the literature ranged between 0.91% and 17.6%. The main histological thyroid malignancy found is micropapillary carcinoma. Despite its less aggressive presentation, these microcarcinomas may grow or develop nodal metastases on follow up. Although bilateral neck exploration with hemi/total thyroidectomy carries the risk of temporary recurrent laryngeal nerve injury or hypoparathyroidism, permanent complications are rare especially when compared to re-do neck surgery. Recently, parathyroid surgeries are going towards minimal invasive procedures, requiring an adequate imaging tool to ensure diagnosis of both diseases. Multiple risk factors for concomitant diseases were hypothesized, the more robust are the common embryologic origin and activation of angiogenic growth factors. Conclusion: NMTC is frequently associated with PHPT especially in endemic goiter areas. With the high prevalence of micropapillary carcinoma and its risks, a partial/total thyroidectomy in addition to parathyroidectomy may be warranted. With the recent need of adequate diagnostic tools, combining both Technetium Sestamibi scintigraphy and thyroid ultrasound improved sensitivities and accuracy of diagnosis, but dual-isotope scintigraphy (I-123 sodium iodide/ 99mTc-sestamibi) seems an attractive modality in hyperparathyroid patients with concomitant suspicious thyroid nodules. However, further studies for validation may be needed.

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Incidental Finding of Papillary Thyroid Carcinoma in the Patients with Primary Hyperparathyroidism

Cited by 15 publications

References 21 publications

Incidental thyroid carcinomas. A retrospective study

Incidental thyroid carcinomas. A retrospective study

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

Primary hyperparathyroidism and non-medullary thyroid cancer- A review

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