Marie-Christine Wright1, Kelly Jensen1,2, Hossam Mohamed1, Carolyn Drake1,2, Khuzema Mohsin3, Dominique Monlezun1,2, Nuha Alsaleh4,5, Emad Kandil4. 1. Tulane University School of Medicine, New Orleans, LA, USA. 2. School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA. 3. Department of Surgery, Tulane University Medical Center, New Orleans, LA, USA. 4. Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University Medical Center, New Orleans, LA, USA. 5. Department of Surgery, Breast and Endocrine Unit, College of Medicine King Saud University, Riyadh, Saudi Arabia.
Abstract
BACKGROUND: Thyroid abnormalities have been found intraoperatively during parathyroidectomy and have resulted in concomitant thyroidectomy. The identification of concomitant disease is important prior to primary operation in order to minimize reoperations. This study investigates the incidence of concomitant primary hyperparathyroidism (PHPT) and thyroid nodular disease in patients undergoing thyroidectomy or parathyroidectomy. METHODS: We performed a retrospective review of prospectively gathered data for 621 patients who underwent thyroidectomy, parathyroidectomy, or both at Tulane Medical Center. Information obtained included initial referral, initial thyroid stimulating hormone (TSH), initial parathyroid hormone (PTH), fine needle aspiration (FNA) results, ultrasound results, type of operation performed, final diagnosis, and final pathology. RESULTS: Among the 400 patients referred primarily for thyroid disease, 13.50% underwent a thyroidectomy and parathyroidectomy (PTX) simultaneously and 10.75% received a final diagnosis of thyroid and concomitant parathyroid disease. Among the 103 patients referred primarily for parathyroid disease, 26.21% underwent a PTX and thyroidectomy and 24.27% received a final diagnosis of both thyroid and parathyroid disease. Patients referred primarily for parathyroid disease were more likely to receive a final diagnosis of both parathyroid and thyroid disease and were more likely to undergo a combined operation. CONCLUSIONS: Concomitant thyroid and parathyroid disease occur and preoperative analysis is important to avoid increased complications from reoperations.
BACKGROUND: Thyroid abnormalities have been found intraoperatively during parathyroidectomy and have resulted in concomitant thyroidectomy. The identification of concomitant disease is important prior to primary operation in order to minimize reoperations. This study investigates the incidence of concomitant primary hyperparathyroidism (PHPT) and thyroid nodular disease in patients undergoing thyroidectomy or parathyroidectomy. METHODS: We performed a retrospective review of prospectively gathered data for 621 patients who underwent thyroidectomy, parathyroidectomy, or both at Tulane Medical Center. Information obtained included initial referral, initial thyroid stimulating hormone (TSH), initial parathyroid hormone (PTH), fine needle aspiration (FNA) results, ultrasound results, type of operation performed, final diagnosis, and final pathology. RESULTS: Among the 400 patients referred primarily for thyroid disease, 13.50% underwent a thyroidectomy and parathyroidectomy (PTX) simultaneously and 10.75% received a final diagnosis of thyroid and concomitant parathyroid disease. Among the 103 patients referred primarily for parathyroid disease, 26.21% underwent a PTX and thyroidectomy and 24.27% received a final diagnosis of both thyroid and parathyroid disease. Patients referred primarily for parathyroid disease were more likely to receive a final diagnosis of both parathyroid and thyroid disease and were more likely to undergo a combined operation. CONCLUSIONS: Concomitant thyroid and parathyroid disease occur and preoperative analysis is important to avoid increased complications from reoperations.
Entities:
Keywords:
Thyroidectomy; parathyroidectomy; thyroid cancer (TC); thyroid nodules