Symptomatic Primary Hyperparathyroidism as a Risk Factor for Differentiated Thyroid Cancer

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Primary hyperparathyroidism (PHPT) is a common endocrine disorder.
• Co-occurring thyroid disease and differentiated thyroid cancer (DTC) are more prevalent in PHPT patients.
• This study investigates symptomatic PHPT patients with and without DTC to identify risk factors.

Purpose of the Study:

• To characterize symptomatic PHPT patients with and without DTC.
• To analyze the frequency of DTC in PHPT patients.
• To determine risk factors associated with DTC in PHPT.

Main Methods:

• Consecutive study of 59 symptomatic PHPT patients (2013-2015), excluding subclinical and syndromic forms.
• Comparison of clinical and biochemical data between patients with and without DTC.
• Utilized thyroid ultrasound, technetium-99m-methoxyisobutyl isonitrile (TC-MIBI) scintigraphy, and expert surgical assessment.

Main Results:

• Papillary thyroid cancer (PTC) was found in 12 patients (20.3%).
• Patients with PTC were older (62 ± 9.5 years) than those without (52 ± 15.8 years).
• Higher preoperative intact parathyroid hormone (iPTH) levels were linked to PTC (OR 5.16, p=0.03).

Conclusions:

• Differentiated thyroid cancer (DTC) is common in symptomatic primary hyperparathyroidism (PHPT).
• Thyroid nodules in PHPT patients require thorough investigation prior to parathyroidectomy.
• Elevated parathormone (PTH) levels in symptomatic PHPT indicate an increased risk of DTC.