Thyroid cancer ıncidence in parathyroidectomy concominant with thyroidectomy
Selman Emirikçi, Beyza Özçınar, Gizem Öner, Nail Omarov, Orhan Ağcaoğlu, Yiğit Soytaş, Nihat Aksakal, Fatih Yanar, Umut Barbaros, Yeşim Erbil
Department of General Surgery, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
Objective: Primary hyperparathyroidism (PHPT) is often seen in conjunction with an underlying thyroid disorder. Imaging methods are used to determine the location of the parathyroid adenoma and thyroid nodules and thyroid cancer. The aim of this study was the detection rate of thyroid cancer while performing parathyroidectomy and thyroidectomy in patient of primer hyperparathyroidism.
Material and Methods: Files of all patients were operated with the diagnosis of PHPT patients who underwent thyroidectomy analyzed. Parathyroid pathology, surgical procedures, indications of thyroid surgery, and pathology results were recorded retrospectively. Indications for thyroid surgery; presence of suspicious thyroid nodules in ultrasonography, increase in size of thyroid nodules in follow-up ultrasound or presence of suspicious thyroid FNA findings. Rates of thyroid cancer detection were investigated in precise pathology reports.
Results: Eighty three patients with a diagnosis of PHPT performed parathyroidectomy with concurrent thyroidectomy were included in the study in Department of General Surgery, İstanbul University İstanbul Faculty of Medicine. 18 patients were male (22%) and 65 were women (78%). The median age was 53 (18-70) years. The primary indication for parathyroidectomy was primary hyperparathyroidism in all patients. 29 patients (35%) was performed lobectomy + istmectomy in addition to parathyroidectomy, 20 patients (24%) was performed bilateral subtotal thyroidectomy , 23 patients (28%) was performed bilateral total thyroidectomy and 11 patients (13%) was performed total thyroidectomy on one side and was performed near total thyroidectomy to the other side. Indications of the thyroidectomy was just presence of thyroid nodules till to the beginning of 2000 years (20 patients, 24%). The remaining 63 patients, in 25 patients (30%) the presence of multiple nodules can not be followed up ultrasonography, in 33 patients (40%) suspicious nodule in USG, in 2 patients (2%) because of the nodule that grows between two follow-up and 3 patients ( 4%) were operated because of suspicious nodules detected in FNAB. Five patients (6%) were diagnosed as papillary thyroid cancer. Four of this patients were micropapillary cancer .
Conclusion: Imaging of pathological parathyroid to determine the localization after the diagnosis of PHPT is useful in predicting the accompanying other pathologies. Before all parathyroid surgery thyroid nodules should be evaluated, if the nodule has an indication for surgery, thyroid surgery should be considered at the same time with parathyroid surgery.
Keywords: Primary hyperparathyroidism, parathyoid adenoma, thyroid cancer, papillary cancer, ultrasonography
Ethical committee approval was not taken since this is a retrospective study.
In this study patient’s approval was not taken. The results of previous surgeries were collected in this study. There is not any positive or negative effect on patient’s treatment.
Concept - Y.E., B.Ö.; Design - B.Ö., S.E.; Supervision - B.Ö., Y.E.; Materials - S.E., G.Ö., N.O., O.A.; Data Collection and/or Processing - S.E., G.Ö., N.O., O.A.; Analysis and/or Interpretation - B.Ö., Y.E.; Literature Review - O.A., B.Ö.; Writer - S.E., B.Ö.; Critical Review - B.Ö., Y.E.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.