Endocrine Abstracts

Introduction: Retrospective analysis has shown that approximately 17–84% of patients suffering from primary hyperparathyroidism have a concomitant thyroid disease. However, it still remains controversial whether these two pathologies happen coincidental or are caused by specific risk factors or genetic changes. In this study we aimed to evaluate concurrently detected thyroid pathologies in patients who underwent surgery for primary hyperparathyroidism.

Methods: We conducted a retrospective study in 75 patients who underwent surgery for primary hyperparathyroidism between 2011 and 2017. Laboratory examination results were recorded and patients underwent preoperative 99 m-technetium sesta-MIBI scan (MIBI) and neck ultrasound (US).

Results: The mean age of participants was 56±12.52 years (Extremes: 28–72) and the sex ratio (Women/Men) was 4.1. Laboratory investigation revealed primary hypothyroidism in 15 patients and hyperthyroidism in three patients. Preoperative thyroid US revealed thyroiditis in four patients (10%), a solitary nodule in 18 patients (24%), multinodular goiter in 18 (24%), and normal findings in 35 cases (47%). Collectively, the prevalence of thyroid disease was 53%. Of 75 parathyroidectomy procedures, 14 patients (18%) underwent simultaneous total or partial thyroidectomy. Indications were suspicious nodule in 11 patients and hyperthyroidism in three patients. Postoperative histopathological examination confirmed the diagnosis of papillary thyroid carcinoma in three patients.

Conclusion: Co-occurrence of thyroid diseases and primary hyperparathyroidism is common. Moreover, coexisting thyroid carcinoma has been reported in patients with PHPT. Although the probability of concomitant thyroid cancer is low, screening for thyroid lesions in patients with primary hyperparathyroidism is recommended. This identification is important prior to parathyroid operation in order to minimize surgical complications, patient discomfort, and costs. Therefore, TSH measurement and preoperative thyroid ultrasound should be performed to patients with primary hyperparathyroidism.