title: Concomitant thyroid lesions in patients with primary hyperparathyroidism.
abstract: BACKGROUND
  Concomitant thyroid pathologies in patients with primary hyperparathyroidism (PHPT) present a challenge in the clinical and surgical decision-making for these patients. In this study, we aimed to evaluate concomitant thyroid pathologies in patients who underwent operations for PHPT to determine the sensitivity (Sn) of neck ultrasonography (US) and Tc99m sestamibi scintigraphy in detecting parathyroid adenoma. We also aimed to determine the clinical impact of preoperative neck US in patients with PHPT.
  
  
  METHODS
  One hundred thirty-eight patients with PHPT were included in this retrospective study. All patients underwent preoperative Tc99m sestamibi scintigraphy and/or thyroid US. Nodules of ≥1 cm or <1 cm with suspicious US features underwent fine needle aspiration biopsy (FNAB).
  
  
  RESULTS
  Preoperative thyroid US revealed that 93.5% of patients with PHPT had thyroid abnormalities and 66.7% of patients had at least one thyroid nodule. Postoperative histopathology results showed that 79.2% of patients had benign thyroid disease and 20.8% of patients had malignant thyroid disease. In the detection of parathyroid adenoma, US had 89.1% Sn and Tc99m sestamibi scintigraphy had 82.6% Sn.
  
  
  CONCLUSIONS
  We recommend the routine use of US in combination with Tc99m sestamibi scintigraphy, especially in endemic goiter regions, to detect any concomitant thyroid disease and thus determine the best surgical strategy for patients with PHPT.
authors.affiliation: Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey. Electronic address: neslihan_cuhaci@yahoo.com.
authors.forename: Neslihan
authors.initials: N
authors.lastname: Cuhaci
authors.affiliation: Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
authors.forename: Didem
authors.initials: D
authors.lastname: Ozdemir
authors.affiliation: Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
authors.forename: Burcak
authors.initials: B
authors.lastname: Polat
authors.affiliation: Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Arpacı
authors.affiliation: Ataturk Education and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Yıldırım
authors.affiliation: Ataturk Education and Research Hospital, Department of Pathology, Ankara, Turkey.
authors.forename: Aylin Kılıc
authors.initials: AK
authors.lastname: Yazgan
authors.affiliation: Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of General Surgery, Ankara, Turkey.
authors.forename: Samet
authors.initials: S
authors.lastname: Yalcın
authors.affiliation: Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of General Surgery, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kılıc
authors.affiliation: Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ersoy
authors.affiliation: Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Cakir
mesh_terms: D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D013959:Thyroid Diseases / Q000150:complications* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014463:Ultrasonography
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
keywords: Tc99m sestamibi scintigraphy; primary hyperparathyroidism; thyroid disorder; thyroid pathology; ultrasonography