Hyperparathyroidism associated with thyroid pathology.
BACKGROUND
The pathological association between thyroid and parathyroid gland disease is here discussed. The multiphase analyzer has revealed a new type of subclinical primary hyperparathyroidism (HPP) and the role of surgery in these cases is not clear.


METHODS
This is a prospective study of all cases of thyroid disease in association with parathyroid disease treated surgically in our Institute from July 1999 to June 2001.


RESULTS
Of the 221 thyroidectomies carried out, 29 patients had an elevated preoperative serum level of parathyroid hormone (PTH). An ultrasonography examination was performed on all patients and a preoperative scanning with 99Tc-MIBI on 11 of 29 patients. We examined intraoperatively 19 cases of HPP (14 parathyroid adenoma, 5 hyperplasia). In 10 cases we observed a normal size of the parathyroid gland and we did not perform a parathyroidectomy.


CONCLUSIONS
All patients with elevated serum parathyroid hormone and serum calcium levels before thyroidectomy should be considered candidates also for surgery to the parathyroid glands. The pathological association between thyroid and parathyroid gland diseases is not rare. We must conduct an accurate neck exploration in all these cases.
Sianesi
Mario
M
Institute of General Surgery and Organ Transplant, University of Parma, Italy. paolofelisso@hotmail.com
Del Rio
Paolo
P
Arcuri
Maria Francesca
MF
Iapichino
Gioacchino
G
Giuseppe
Robuschi
R
D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013959:Thyroid Diseases / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome