Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study.
BACKGROUND
Thyroid disease and hyperparathyroidism are the most common endocrine disorders. The incidence of thyroid disease in patients with hyperparathyroidism ranges in the different series from 17 to 84%, and thyroid cancer occurs with an incidence ranging from 2 to 15%.


OBJECTIVE
The aim of our study was to analyze the management of elderly patients with concomitant thyroid and parathyroid disease in order to define the best surgical therapeutic strategy and avoid reoperations associated with a higher risk of complications.


METHODS
All consecutive patients (64 patients, age range 60-75 years), undergoing surgery for hyperparathyroidism, from January 2011 to June 2014, were retrospectively evaluated. Enrolled patients were divided into two study groups of patients affected by hyperparathyroidism with or without a concomitant thyroid disease.


RESULTS
Out of 64 patients enrolled in our study (24 men, age range 60-75 years), affected by hyperparathyroidism, 34 had an associated thyroid disease and were treated with total thyroidectomy and parathyroidectomy. The group, who underwent parathyroidectomy associated with thyroidectomy, had no greater complications than the group receiving only parathyroidectomy.


CONCLUSIONS
Thyroid disease must be excluded in patients affected by hyperparathyroidism. It is difficult to determine whether hyperparathyroidism can be considered a risk factor for thyroid disease, but an accurate preoperative study is essential for a surgery able to treat both thyroid and parathyroid disease. In this way, we avoid the elderly patient, with associated morbidity and increased surgical risk, to undergo a reoperation for thyroid disease, burdened with major complications.
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy. sandrapana78@gmail.com.
Alessandra
A
Panarese
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
Vito
V
D'Andrea
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
Stefano
S
Pontone
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
Pasqualino
P
Favoriti
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
Daniele
D
Pironi
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
Stefano
S
Arcieri
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
Angelo
A
Filippini
Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, V.le Regina Elena n.324, 00161, Rome, Italy.
Salvatore
S
Sorrenti
D000368:Aged; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D012086:Reoperation; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
Hyperparathyroidism; Parathyroidectomy; Thyroid disease; Thyroidectomy