CONCOMITANT THYROID DISEASES IN PRIMARY HYPERPARATHYROIDISM PATIENTS SUBMITTED TO PARATHYROIDECTOMY markogiannakis@yahoo.com

PW06-07

CONCOMITANT THYROID DISEASES IN PRIMARY HYPERPARATHYROIDISM PATIENTS SUBMITTED TO PARATHYROIDECTOMY

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Greece

Oral or Poster

Our objective was to analyze concomitant thyroid diseases in primary hyperparathyroidism cases undergoing parathyroidectomy during a 14 years' period.

This is a prospective study of all primary hyperparathyroidism patients submitted to parathyroidectomy from 1/1/2011 until 31/12/2024. Apart from standard parathyroid preoperative laboratory investigation, serum FT3, T3, FT4, T4, TSH, anti-Tg, anti-TPO and calcitonin were evaluated. All cases underwent neck ultrasound and sestamibi scan while FNA was performed in every suspicious thyroid nodule.

A total of 342 cases were included in the study (female:81.9%, mean age:56.6 years). Diagnosis was solitary parathyroid adenoma in 93%, primary hyperplasia 5%, double adenoma 1.7% and parathyroid carcinoma in 0.3%. A significant proportion of the patients (n=146, 42.7%) presented at least one concomitant thyroid disorder. Preoperative thyroid disease diagnosis was multinodular goiter in 108 (31.6%), Hashimoto’s thyroiditis in 50 (14.6%), toxic multinodular goiter in 5 (1.5%), papillary cancer in 4 (1.2%), solitary nodule in 3 (0.9%), Graves’ disease in one (0.3%) and medullary carcinoma in one case (0.3%). In addition to parathyroidectomy, 50 patients (14.6%) underwent a total thyroidectomy and twelve (3.5%) hemithyroidectomy. Histopathology examination reported papillary thyroid cancer in 5.3% of the total group (n=18), representing 29% of the thyroidectomy and 12.3% of the thyroid disease coexistence cases accordingly.

Primary hyperparathyroidism patients waiting for parathyroidectomy often suffer from several concomitant thyroid diseases highlighting the importance of preoperative evaluation with thyroid function tests and neck ultrasound in these cases. A high suspicion for thyroid cancer coexistence in such patients may be warranted.