Neslihan Cuhaci1, Didem Ozdemir2, Burcak Polat3, Dilek Arpacı3, Nilüfer Yıldırım4, Aylin Kılıc Yazgan5, Samet Yalcın6, Mehmet Kılıc6, Reyhan Ersoy2, Bekir Cakir2. 1. Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey. Electronic address: neslihan_cuhaci@yahoo.com. 2. Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey. 3. Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey. 4. Ataturk Education and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey. 5. Ataturk Education and Research Hospital, Department of Pathology, Ankara, Turkey. 6. Yildirim Beyazit University, Faculty of Medicine, Ataturk Education and Research Hospital, Department of General Surgery, Ankara, Turkey.
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. CONCLUSION: 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.
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. CONCLUSION: 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: Lindsay Hargitai; Maria Schefner; Tatjana Traub-Weidinger; Alexander Haug; Melisa Arikan; Christian Scheuba; Philipp Riss Journal: Langenbecks Arch Surg Date: 2022-01-21 Impact factor: 2.895