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Journal of Zhejiang University SCIENCE B 2007 Vol.8 No.9 P.626~631

http://doi.org/10.1631/jzus.2007.B0626


Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease


Author(s):  ZHENG Yi-xiong, XU Shao-ming, WANG Ping, CHEN Li

Affiliation(s):  Department of Surgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

Corresponding email(s):   zyx_xxn@hotmail.com, chenli@mail.hz.zj.cn

Key Words:  Hyperparathyroidism, Thyroid diseases, Imaging diagnosis, Surgical treatment


ZHENG Yi-xiong, XU Shao-ming, WANG Ping, CHEN Li. Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease[J]. Journal of Zhejiang University Science B, 2007, 8(9): 626~631.

@article{title="Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease",
author="ZHENG Yi-xiong, XU Shao-ming, WANG Ping, CHEN Li",
journal="Journal of Zhejiang University Science B",
volume="8",
number="9",
pages="626~631",
year="2007",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2007.B0626"
}

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%T Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease
%A ZHENG Yi-xiong
%A XU Shao-ming
%A WANG Ping
%A CHEN Li
%J Journal of Zhejiang University SCIENCE B
%V 8
%N 9
%P 626~631
%@ 1673-1581
%D 2007
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2007.B0626

TY - JOUR
T1 - Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease
A1 - ZHENG Yi-xiong
A1 - XU Shao-ming
A1 - WANG Ping
A1 - CHEN Li
J0 - Journal of Zhejiang University Science B
VL - 8
IS - 9
SP - 626
EP - 631
%@ 1673-1581
Y1 - 2007
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2007.B0626


Abstract: 
The coexistence of thyroid diseases with primary hyperparathyroidism (PHPT) can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study. Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision (about 3 cm), while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter (32.7%), 2 thyroiditis (3.8%), 2 thyroid adenoma (3.8%) and 1 thyroid carcinoma (1.9%) coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultrasonography (US) and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography (CT) and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of associated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

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