Retrospective analysis of the association of nodular goiter with primary and secondary hyperparathyroidism

Abstract

Background: The association of hyperparathyroidism (HPT) with thyroid disease has long been known, but the mechanisms underlying such an association have not yet been clari®ed. Objective: To elucidate the main factors determining this combination of endocrine diseases, in a retrospective multicenter study. Methods: We retrospectively reviewed all patients referred for parathyroid scintigraphy in the period 1990±1999. A total of 487 patients in the age range 17±65 years were selected for the analysis (339 women and 148 men); group A included 241 patients with primary and group B 246 patients with secondary HPT. Results: A total of 124/241 patients in group A (51.5%), but only 92/246 patients in group B (38.2%) had thyroid disorders (notably nodular goiter) associated with HPT P 0X0035X Thyroid disorders were evenly distributed throughout the entire 17±65 years age range in group A, but 17± 40-year-old patients in group B had signi®cantly fewer thyroid disorders than the older patients of the same group (15.5% compared with 43.3%, P , 0X002), as expected in a general population. In patients with primary HPT there was no difference in the prevalence of thyroid disease between women and men, whereas the ratio of women to men in secondary HPT patients with thyroid disease was about 3:1.Conclusions: These results demonstrate an increased prevalence of nodular goiter in patients with primary rather than secondary HPT, and are consistent with a possible role of increased endogenous calcium concentrations (a hallmark of primary, but not of secondary, HPT) as a goitrogenic factor in patients with HPT.

Incidental Finding of Papillary Thyroid Carcinoma in the Patients with Primary Hyperparathyroidism

“…However, most of the cases were diagnosed with multi-nodular goitre and the incidence of malignancy was only 2.6%. This result complies favourably to the previously reported series in which malignancy rates were between 2.0% and 17% (Table 2) [1,[4][5][6]10].…”

“…The incidence of thyroid disorders in patients with pHPT is between 2.5% and 40% while the incidence of pHPT in patients with thyroid disorders is found at a lower rate ranging between 0.3% and 8.7% [4][5][6][7][8][9]. The incidence of thyroid disorders in our series was found to be 37.7%.…”

“…The clinical role of pHPT compared to secondary and tertiary HPT is controversial [5,6]. However, an increased risk of non-parathyroid cancers in patients with pHPT has been reported in several studies [18].…”

Concomitant autoimmune thyroiditis and primary hyperparathyroidism – random association? Two cases report

“…High PTH values were also discussed as a possible proliferation factor, but the prevalence of thyroid diseases is higher in primary than in secondary PHPT, while PTH values are significantly higher in the secondary form. Other growth factors, as EGF (epithelial growth factor) or IGF1, increased in PHPT, have also a goitrogenic effect [14].…”

Tumor Pardo Multifocal Como Manifestación Del Hiperparatiroidismo Primario Por Adenoma Paratiroideo Asociado a Carcinoma Papilar De Tiroides

“…La asociación de un micro carcinoma papilar tiroideo con el adenoma paratiroideo fue descrita por primera vez en 1956 por Ogburn y colaboradores 34 , con una frecuencia que oscila entre el 3,1-17% según los diferentes reportes 35 . no existe una clara asociación entre estas dos patologías, se han documentado posibles etiologías como el efecto oncogénico de la hipercalcemia 36 , el incremento del factor de crecimiento epitelial y el factor de crecimiento similar a la insulina 34,37 , bajas dosis de radiación en cabeza y cuello en la infancia que pueden relacionarse con la sincronía de tumores tiroideos y paratiroideos 38 .…”