Display options
Share it on

Ulus Cerrahi Derg. 2015 Aug 18;31(4):214-7. doi: 10.5152/UCD.2015.2666. eCollection 2015.

Thyroid cancer incidence in simultaneous thyroidectomy with parathyroid surgery.

Ulusal cerrahi dergisi

Selman Emirikçi, Beyza Özçınar, Gizem Öner, Nail Omarov, Orhan Ağcaoğlu, Yiğit Soytaş, Nihat Aksakal, Fatih Yanar, Umut Barbaros, Yeşim Erbil

Affiliations

  1. Department of General Surgery, ?stanbul University, ?stanbul Faculty of Medicine, ?stanbul, Turkey.

PMID: 26668529 PMCID: PMC4674042 DOI: 10.5152/UCD.2015.2666

Abstract

OBJECTIVE: Primary hyperparathyroidism (PHPT) is often seen in conjunction with an underlying thyroid disorder. Imaging methods that are used to localize the parathyroid adenoma also detect associated thyroid nodules and thyroid cancer. The aim of this study was to detect the rate of thyroid cancer identified while performing parathyroidectomy and thyroidectomy in patients with PHPT.

MATERIAL AND METHODS: Files of all patients who were operated for PHPT and who underwent simultaneous thyroidectomy were analyzed. Data regarding parathyroid pathology, surgical procedures, indications of thyroid surgery, and pathology results were retrospectively recorded. The indications for thyroid surgery included presence of suspicious thyroid nodules in ultrasonography, increase in size of thyroid nodules in follow-up ultrasound, or presence of suspicious thyroid fine needle aspiration biopsy (FNAB) findings. Rates of thyroid cancer detection were investigated according to definite pathology reports.

RESULTS: Eighty-three patients who underwent parathyroidectomy with a diagnosis of PHPT with concurrent thyroidectomy in Department of General Surgery, İstanbul University İstanbul Faculty of Medicine were included in the study. Eighteen patients were male (22%) and 65 were female (78%). The median age was 53 (18-70) years. The primary indication for parathyroidectomy was primary hyperparathyroidism in all patients. The thyroid procedures applied in addition to parathyroidectomy were lobectomy + isthmusectomy in 29 patients (35%), bilateral subtotal thyroidectomy in 20 patients (24%), bilateral total thyroidectomy in 23 patients (28%), and total thyroidectomy on one side and near total thyroidectomy to the other side in 11 patients (13%). The only indication for thyroidectomy was the presence of thyroid nodules until 2000 (20 patients, 24%). Indications in the remaining 63 patients included the presence of multiple nodules that cannot be followed up by ultrasonography in 25 patients (30%), presence of a suspicious nodule on ultrasonography in 33 patients (40%), growth in nodule size in 2 patients (2%), and detection of suspicious findings on FNAB in 3 patients (4%). Five patients (6%) were diagnosed with papillary thyroid cancer, four of whom were micropapillary cancer.

CONCLUSION: Imaging methods performed to localize the pathological parathyroid gland for a diagnosis of PHPT are useful in estimating other accompanying pathologies. Presence of thyroid nodules should be evaluated before all parathyroid procedures, and if the nodule has an indication for surgery, thyroid surgery should be considered at the same operation with parathyroid surgery.

Keywords: Primary hyperparathyroidism; papillary cancer; parathyroid adenoma; thyroid cancer; ultrasonography

References

  1. J Am Coll Surg. 2010 Oct;211(4):536-9 - PubMed
  2. Eur J Endocrinol. 2001 Oct;145(4):429-34 - PubMed
  3. Surgery. 1994 Dec;116(6):966-72; discussion 972-3 - PubMed
  4. Zentralbl Chir. 1995;120(1):43-6 - PubMed
  5. Clin Endocrinol (Oxf). 1995 Nov;43(5):525-30 - PubMed
  6. Surg Clin North Am. 2004 Jun;84(3):787-801 - PubMed
  7. Ann Surg. 2000 Sep;232(3):331-9 - PubMed
  8. Aust N Z J Surg. 2000 Apr;70(4):285-7 - PubMed
  9. J Endocrinol Invest. 1999 Mar;22(3):191-7 - PubMed
  10. Arch Surg. 1990 Oct;125(10):1327-31 - PubMed
  11. J Surg Res. 2009 Aug;155(2):254-60 - PubMed
  12. Surgery. 1983 Dec;94(6):893-900 - PubMed
  13. Surgery. 1977 Sep;82(3):296-302 - PubMed
  14. Endocrinol Metab Clin North Am. 2007 Sep;36(3):707-35, vi - PubMed
  15. J Surg Res. 2009 Jun 15;154(2):317-23 - PubMed
  16. J Clin Endocrinol Metab. 1947 Feb;7(2):152-8 - PubMed
  17. Biomed Pharmacother. 2000 Jun;54 Suppl 1:108s-111s - PubMed
  18. Surgery. 1999 Dec;126(6):1132-7; discussion 1137-8 - PubMed
  19. Proc Staff Meet Mayo Clin. 1956 May 16;31(10):295-8 - PubMed

Publication Types