Parathyroid adenomas discovered incidentally during explorations of the thyroid

Attie, Joseph N.; Estrin, Joseph; Khafif, Rene A.; Dweck, F.

doi:10.1016/0002-9610(67)90013-x

Cited by 30 publications

(15 citation statements)

References 6 publications

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“…The presence of a palpable parathyroid mass, in a patient with primary hyperparathyroidism, raises a high index of suspicion for parathyroid carcinoma 1,2 . Less common causes of palpable parathyroid masses include parathyroid adenomas 4−6 and parathyroid cysts 7,8 …”

Section: Introductionmentioning

confidence: 99%

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Weymouth

Serpell

Chambers³

2003

ANZ Journal of Surgery

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Parathyroid and thyroid disease often occur simultaneously. Concomitant parathyroid pathology should be considered, even in the absence of biochemical and radiological evidence, at neck exploration for thyroid disease. Macroscopic identification of parathyroid disease at neck exploration can be difficult when within the thyroid gland capsule. Cytology and imaging of parathyroid adenomas may, on occasion, mimic follicular thyroid neoplasms.

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Section: Introductionmentioning

confidence: 99%

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Weymouth

Serpell

Chambers³

2003

ANZ Journal of Surgery

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“…The coexistence of hyperparathyroidism and thyroid tumors, chronic thyroiditis, and hypothyroidism has been the subject of numerous publications 13‐30 . This suggests that a pathophysiologic relationship may exist between these two endocrine glands.…”

Section: Introductionmentioning

confidence: 99%

Hyperparathyroidism Associated With a Chronic Hypothyroid State

et al. 1997

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Reports of the coexistence of hyperparathyroidism and thyroid disease have raised the issue of a possible etiologic relationship. The present study tests the hypothesis that chronic elevation of thyroid-stimulating hormone (TSH) is related to the development of hyperparathyroidism. Four groups of 60 female rats were treated as follows: group 1, control; group 2, propylthiouracil (PTU) 0.0025%; group 3, PTU 0.0025% plus thyroxine, 5 microg two times per week; and group 4, only thyroxine. The animals' serum calcium, phosphorus, TSH, thyroxine, and parathyroid hormone (PTH) levels were evaluated at 0, 6, 12, and 18 months. Significant elevation of TSH was sustained throughout the 18 months in groups 2 and 3. The PTH levels were also significantly elevated in both group 2 and group 3 animals (P = 0.02). The histopathologic features of the parathyroids were evaluated at 18 months. In the group 2 (PTU only) animals, which had profound hypothyroid, 44% developed parathyroid adenomas. In the group 3 (PTU plus thyroxine) animals, who had mildly elevated TSH levels, 53% developed parathyroid adenomas. These findings are consistent with the hypothesis that prolonged TSH stimulation may lead to hyperparathyroidism in the rat model.

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“…Its prevalence is up to 4 per 1000 in women aged over 60 years, and its incidence is approximately 42 per 100 000 (Shoback et al 2001). The prevalence of thyroid nodules has been estimated to be 4% of the population, with an incidence of 5% in persons over age 60 (Greenspan 2001 preoperatively or at neck exploration in patients with primary HPT has long been described (Attie et al 1967). Moreover, a higher incidence of thyroid tumours in patients with primary HPT has been observed since the 1970s (Kaplan et al 1971).…”

Section: Introductionmentioning

confidence: 99%

Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy.

Lumachi¹,

Marzola²,

Zucchetta³

et al. 2003

Endocrine-Related Cancer

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A series of 112 consecutive patients with primary hyperparathyroidism who underwent both high-resolution neck ultrasonography (US) and Tc-pertechnetate subtraction scintigraphy (SS) prior to successful parathyroidectomy was reviewed. There were 29 (25.9%) men and 83 (74.1%) women, with a median age of 58 years (range 13-78 years). Patients were divided into two groups, according to the preoperative US findings: group A (87 patients, 77.7%) without thyroid diseases, and group B (25 patients, 22.3%) with either multinodular goitre or a solitary nontoxic thyroid nodule. In group B patients partial or total thyroidectomy was also performed, according to the intraoperative findings and frozen-section examination results. Final histopathology showed 99 (88.4%) solitary parathyroid (PT) adenomas and 3 (2.7%) PT carcinomas, while 10 (8.9%) patients had a multiglandular disease. The sensitivity and positive predictive value (PPV) were (group A vs group B) 79.8% vs 70.8% (P = 0.25) and 95.7% vs 94.4% (P = 0.58) for US, and 83.3% vs 87.0% (P = 0.47) and 95.9% vs 90.9% (P = 0.32) for SS respectively. Better but similar (P = not significant) results were obtained in patients with solitary PT tumours: 81.5% vs 77.8% (US) and 85.0 vs 94.1% (SS) sensitivity; 97.1% vs 93.3% (US) and 95.8% vs 88.9% (SS) PPV. Overall, the combination of US and SS was 92.9% sensitive (group A = 93.1%, group B = 92.0%; P = 0.55), and the PPV reached 100% in each group. In conclusion, in patients with primary hyperparathyroidism the results of both US and SS are independent of coexistent thyroid disease, especially in patients with solitary PT tumours.

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Parathyroid adenomas discovered incidentally during explorations of the thyroid

Cited by 30 publications

References 6 publications

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Hyperparathyroidism Associated With a Chronic Hypothyroid State

Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy.

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