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Hyperparathyroidism after neck irradiation
T J Christmas1, C R Chapple, J G Noble
1Department of Urology, Middlesex Hospital, London, UK.
The British Journal of Surgery
|September 1, 1988
Summary
Neck irradiation, particularly for benign conditions, significantly increases the risk of developing hyperparathyroidism (HPT). This retrospective study highlights a 0.7% incidence of HPT in patients with prior neck radiation exposure.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Neck irradiation is a known risk factor for thyroid and parathyroid diseases.
- Hyperparathyroidism (HPT) can occur years after radiation exposure.
Purpose of the Study:
- To evaluate the incidence and characteristics of hyperparathyroidism in patients with a history of neck irradiation.
- To assess the relationship between radiation type, latency period, and parathyroid pathology.
Main Methods:
- Retrospective review of 1550 surgically treated hyperparathyroidism cases over 30 years.
- Analysis of patient history for prior neck irradiation, including indication and radiotherapy type.
- Review of parathyroid histology and concurrent thyroid disease.
Main Results:
- Ten cases (0.7%) of hyperparathyroidism had a history of neck irradiation.
- The mean latency period between irradiation and HPT diagnosis was 32 years.
- Parathyroid histology included adenoma (6 cases), carcinoma (3 cases), and hyperplasia (1 case).
- Patients receiving radioactive iodine had a shorter latency period (5 years) compared to external beam therapy (44 years).
Conclusions:
- Neck irradiation confers an increased risk of developing parathyroid adenoma and carcinoma.
- These findings support the contraindication of neck irradiation, especially for benign conditions.
- Long-term surveillance for HPT is warranted in individuals with a history of neck radiation.