title: Preoperative and postoperative evaluation of thyroid disease in patients undergoing surgical treatment of primary hyperparathyroidism.
abstract: OBJECTIVE
  To evaluate the occurrence of thyroid disease in patients undergoing parathyroidectomy for primary hyperparathyroidism.
  
  
  METHODS
  In this case series, records of all patients with a diagnosis of primary hyperparathyroidism who underwent parathyroidectomy between January 2005 and December 2008 in our clinic were analyzed retrospectively. Preoperatively, all patients were evaluated with ultrasonography and parathyroid scintigraphy; when needed, thyroid scintigraphy and ultrasound-guided fine-needle aspiration biopsy (FNAB) were used. All patients underwent standard neck exploration. Postoperative histopathologic findings of thyroid tissue were classified as nodular/multinodular hyperplasia, Hashimoto thyroiditis, papillary thyroid carcinoma, or normal.
  
  
  RESULTS
  Fifty-one women and 9 men were included. In the 60 patients, preoperative ultrasonography revealed thyroiditis (without nodules) in 13 (22%), a solitary nodule in 9 (15%) (coexistent with thyroiditis in 7 patients), multinodular goiter in 24 (40%) (coexistent with thyroiditis in 5 patients), and normal findings in 14 (23%). Rates of thyroiditis and nodular goiter were 42% and 55%, respectively. Collectively, prevalence of thyroid disease was 77%. Total thyroidectomy was performed in 27 patients, and hemithyroidectomy was performed in 15 patients. Indications for total thyroidectomy were nondiagnostic or suspicious FNAB results in 5 patients, hyperthyroidism in 4 patients, ultrasonography findings in 11 patients, and intraoperatively recognized suspicious nodularity in 7 patients. Postoperatively, thyroid carcinoma was diagnosed in 9 patients (15%).
  
  
  CONCLUSIONS
  Thyroid disease, particularly thyroid carcinoma, is common in patients with primary hyperparathyroidism. This association should be considered when selecting the surgical procedure. Intraoperative evaluation of the thyroid is as important as preoperative evaluation with ultrasonography and FNAB in patients with thyroid disease and primary hyperparathyroidism.
authors.affiliation: Department of Endocrinology and Metabolism, Ankara Ataturk Education and Research Hospital, Bilkent, Ankara, Turkey. kamilegul@yahoo.com
authors.forename: Kamile
authors.initials: K
authors.lastname: Gul
authors.forename: Didem
authors.initials: D
authors.lastname: Ozdemir
authors.forename: Birol
authors.initials: B
authors.lastname: Korukluoglu
authors.forename: Pamir Eren
authors.initials: PE
authors.lastname: Ersoy
authors.forename: Raci
authors.initials: R
authors.lastname: Aydin
authors.forename: Serdar Nevzat
authors.initials: SN
authors.lastname: Ugras
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ersoy
authors.forename: Bekir
authors.initials: B
authors.lastname: Cakir
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014463:Ultrasonography