title: Preoperative evaluation of thyroid pathology in patients with primary hyperparathyroidism.
abstract: In parathyroidectomy, it has been recognized that a shift to a minimally invasive procedure may be accompanied by a possibility of missing thyroid pathology. However, only a few findings concerning preoperative thyroid evaluation have been reported. We investigated the prevalence of concomitant thyroid pathology by preoperative neck ultrasonography (US) in patients with primary hyperparathyroidism. There were 85 patients (66 women, 19 men; mean age 57 years) in the study group. The mean preoperative calcium level was 11.2mg/dL, and the mean intact parathyroid hormone level was 206 pg/mL. All patients underwent neck US following fine-needle aspiration biopsy (FNAB). Of the 85 patients, 21 (24.7%) had thyroid nodules. Among 21 patients with thyroid nodules, 9 (10.6%) had malignant thyroid tumors, while 12 (14.1%) patients had benign thyroid nodules including multinodular goiter. Of the 9 patients with malignant thyroid nodules, 4 had papillary carcinomas with lymph node metastases. The prevalence of thyroid disease associated with hyperparathyroidism is high, and evaluation of the thyroid pathology by US enables the shift from bilateral neck exploration to the minimally invasive parathyroid surgery.
authors.affiliation: Department of Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. e05021@h.u-tokyo.ac.jp
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Ogawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Kammori
authors.forename: Ei-Ichi
authors.initials: E
authors.lastname: Tsuji
authors.forename: Hajime
authors.initials: H
authors.lastname: Kanauchi
authors.forename: Rie
authors.initials: R
authors.lastname: Kurabayashi
authors.forename: Kotoe
authors.initials: K
authors.lastname: Terada
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Mimura
authors.forename: Michio
authors.initials: M
authors.lastname: Kaminishi
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002118:Calcium / Q000097:blood; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary / Q000601:surgery; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D015994:Incidence; D033162:Incidental Findings; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D011300:Preoperative Care; D015995:Prevalence; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium