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Surgeon-driven thyroid interrogation of patients presenting with primary hyperparathyroidism
David A Sloan1, Daniel L Davenport1, Roberta J Eldridge1
1Department of Surgery, University of Kentucky College of Medicine, Lexington, KY.
Journal of the American College of Surgeons
|February 18, 2014
Summary
A comprehensive thyroid evaluation for primary hyperparathyroidism (pHPT) patients is recommended. Many patients referred for parathyroid surgery have undiagnosed thyroid conditions, some requiring treatment.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroidology
Background:
- Primary hyperparathyroidism (pHPT) is a growing endocrine disorder.
- Patients with pHPT often have coexisting thyroid conditions.
- Early detection and management of thyroid pathology are crucial.
Purpose of the Study:
- To assess the impact of a thyroid interrogation protocol on surgical treatment for pHPT patients.
- To determine the prevalence of thyroid abnormalities in patients undergoing parathyroidectomy.
- To evaluate the necessity of combined parathyroid and thyroid surgery.
Main Methods:
- Retrospective review of prospectively gathered data.
- Analysis of 468 parathyroidectomy (PTX) patients between January 2008 and October 2012.
- Inclusion of clinical thyroid evaluation and thyroid ultrasound.
Main Results:
- 61% of patients showed thyroid abnormalities on ultrasound.
- 22% had unrecognized palpable thyroid issues; 31% had known thyroid disease.
- Thyroid surgery was combined with PTX in 18.4% of cases, identifying 4.9% malignancy.
Conclusions:
- A significant number of pHPT patients exhibit thyroid pathology.
- Comprehensive thyroid evaluation is essential for patients referred for PTX.
- Combined surgery identified significant benign and malignant thyroid disease.
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