Benign and malignant thyroid gland diseases in the patients with primary hyperparathyroidism

Çelık, Mehmet; Güldiken, Sibel; Ayturk, Semra; Bulbul, Buket Yilmaz; Taştekin, Ebru; Can, Nuray; Sezer, Atakan; Üstün, Funda; Küçükarda, Ahmet

doi:10.4103/2229-516x.205806

“…When we compared the patients with PTC with those who were with benign cytology, we found no difference in terms of demographic characteristics and clinical parameters. In three studies, two of which were conducted in Türkiye, no significant difference was found between benign and malignant groups in patients with hyperparathyroidism in terms of age, gender, preoperative PTH, Ca, P, 25-OH-D3, 24-hour urinary Ca levels (3,21,22) compatible to our study. In the study of Celik et al ( 22) also anti-TPO levels were compared and no significant difference was found similar to our study.…”

Section: Discussionsupporting

confidence: 84%

Primer Hiperparatiroidili Hastalarda Nodüler Guatr ve Papiller Tiroid Kanseri Birlikteliğinin Değerlendirilmesi

ÇALIŞKAN,

CENGİZ,

DEMİRCİ

2023

Düzce Tıp Fakültesi Dergisi

1

0

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Aim: Primary hyperparathyroidism and differentiated thyroid carcinoma are the most common endocrinological diseases. Since its first definition in the 1950s, nodular goiter and differentiated thyroid carcinoma in patients with primary hyperparathyroidism have been examined in many studies and an increase in cancer incidence has been found. In this study, we aimed to investigate the co-incidence of nodular goiter and differentiated thyroid cancer in patients with primary hyperparathyroidism. Material and Methods: One hundred seventy-two patients who underwent parathyroid surgery in our hospital between 2012 and 2015 were included in this study. Demographic, clinic, and surgical data of the patients were reviewed retrospectively. Results: The mean age of the patients was 54.3±11.3 years and 85.5% (n=147) of them were female. Nodular goiter was observed at a rate of 61.0% (n=105) in preoperative evaluation. Parathyroidectomy was performed in 125 (72.7%) and simultaneous total thyroidectomy was performed in 32 (18.6%) and lobectomy in 15 (8.7%) of the patients. Histopathologically, 94.8% (n=163) were interpreted as adenoma, 2.9% (n=5) as parathyroid hyperplasia, and 2.3% (n=4) as parathyroid carcinoma. Patients with papillary thyroid carcinoma (n=30) and benign (n=17) histopathologically were compared in terms of clinical and laboratory characteristics, and no significant difference was observed in any parameter. Conclusion: There was no significant increase in thyroid nodularity, but a significant increase was found in differentiated thyroid carcinoma incidence in patients with primary hyperparathyroidism in this study in accordance with the literature. This finding highlights the importance of preoperative thyroid evaluation in this patient group.

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“…PTC is the most common type of the malignant thyroid lesions synchronous with PHPT [ 13 – 15 ]. Ogburn and Black were the first to report the concomitant PTC in PHPT patients in 1956 [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the higher PTC prevalence in the asymptomatic PHPT patients in this inpatient cohort might be also caused by the selection bias, since patients with potential malignant thyroid lesions had higher possibility of hospitalization. PTC is the most common type of the malignant thyroid lesions synchronous with PHPT [13][14][15]. Ogburn and Black were the first to report the concomitant PTC in PHPT patients in 1956 [16].…”

Section: Discussionmentioning

confidence: 99%

Differences in Clinicopathological Characteristics of Papillary Thyroid Carcinoma between Symptomatic and Asymptomatic Patients with Primary Hyperparathyroidism

Liu

¹

,

Guo

²

,

Sang

³

et al. 2021

International Journal of Endocrinology

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Background. Popularization of cervical ultrasound led to higher detection of papillary thyroid carcinoma (PTC) and primary hyperparathyroidism (PHPT), as well as increasing percentage of asymptomatic PHPT in China. Although the coexistence of PTC and PHPT has been reported, it is unknown whether the clinicopathological features of PTC differ between asymptomatic and symptomatic PHPT patients. Methods. We retrospectively reviewed the medical records of 304 PHPT patients treated in our hospital between January 2009 and July 2020, including 217 females and 87 males with the average age of 53.27 ± 13.54 years. Of the 304 patients, 181 were symptomatic PHPT patients and 123 were asymptomatic PHPT patients. We analyzed the laboratory results, postoperative pathology, and the TNM stage of PTC between asymptomatic and symptomatic PHPT patients. Results. Concurrent thyroid nodules were found in 61.51% of PHPT patients, and the prevalence of PTC in thyroidectomized PHPT patients was 29.89% in our cohort. Lower serum parathyroid hormone (PTH) ( p < 0.05 ) and calcium ( p < 0.05 ) were found in PHPT patients with PTC compared to patients with benign thyroid lesion. Compared with the symptomatic PHPT patients, the asymptomatic PHPT patients showed lower serum calcium ( p < 0.05 ), serum chlorine ( p < 0.05 ), alkaline phosphatase ( p < 0.05 ), PTH ( p < 0.05 ), and bone turnover markers ( p < 0.05 ) but higher prevalence of thyroid nodules (70.73% versus 55.24%, p < 0.05 ) and PTC (15.44% versus 3.87%, p < 0.05 ). All the PTC in symptomatic PHPT patients were papillary microcarcinoma limited to the thyroid, while 68.42% and 15.78% of the PTC in asymptomatic PHPT patients showed microscopic extrathyroidal extension and lymph node metastases, respectively. Moreover, 36.84% (7/19) of the PTC patients in asymptomatic group showed multifocality, which was much higher than 14.29% (1/7) in the symptomatic group; however, no statistical significance was found ( p = 0.24 ). Conclusions. The concomitant PTC in asymptomatic PHPT patients showed a higher rate of microscopic extrathyroidal invasion when compared to symptomatic PHPT patients. So the FNA is essential to the asymptomatic PHPT patients with suspicious thyroid nodules and once the PTC is confirmed, concurrent parathyroidectomy should be performed with thyroidectomy in asymptomatic PHPT patients.

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Oral kavitede kitle ve eşlik eden insidental papiller tiroid karsinomu ile başvuran normokalsemik primer hiperparatiroidizm olgusu

TOPUZ

¹

,

Tüzün

²

,

ÖZBAY

³

et al. 2022

Cukurova Medical Journal

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Hyperparathyroidism (HPT) is an endocrine disorder characterized by high secretion of parathyroid hormone. Brown tumor is one of the skeletal manifestations of HPT. Its overall prevalence is low (about 0.1%). Involvement of facial bones is extremely rare. The mandible is involved in 4.5% of cases. Primary HPT (PHPT)with vitamin D deficiency worsens the clinical course. Parathyroid adenoma is detected in ectopic places with a rate of 8.5%. 0.2% is intrathyroidal, 2% is located in different neck regions, 4.1% is in the upper mediastinum, and 2.2% is in the lower mediastinum. The prevalence of papillary thyroid cancer (PTC) in PHPT patients has been reported to range from 2% to 15%. In the literature, incidentally detected papillary thyroid cancer in patients with hyperparathyroidism was detected in patients who underwent total thyroidectomy associated with intrathyroidal parathyroid adenoma. In this article, we present a case of incidental papillary thyroid carcinoma with ectopic parathyroid adenoma accompanied by severe vitamin D, and diagnosed during accompanying surgery following a brown tumor was considered after primary hyperparathyroidism was detected. However, the patient was admitted with a mass in the oral cavity, diagnosed before as a pyogenic granuloma with a delayed diagnosis without considering brown tumor because it was normocalcemic. It is the first case in the literature of papillary thyroid carcinoma detected incidentally with ectopic parathyroid adenoma in the thyrothymic region.

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Benign and malignant thyroid gland diseases in the patients with primary hyperparathyroidism

Cited by 5 publications

References 17 publications

Primer Hiperparatiroidili Hastalarda Nodüler Guatr ve Papiller Tiroid Kanseri Birlikteliğinin Değerlendirilmesi

Primer Hiperparatiroidili Hastalarda Nodüler Guatr ve Papiller Tiroid Kanseri Birlikteliğinin Değerlendirilmesi

Differences in Clinicopathological Characteristics of Papillary Thyroid Carcinoma between Symptomatic and Asymptomatic Patients with Primary Hyperparathyroidism

Oral kavitede kitle ve eşlik eden insidental papiller tiroid karsinomu ile başvuran normokalsemik primer hiperparatiroidizm olgusu

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