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Parathyroid incidentalomas in normocalcemic patients during thyroid surgery
B M Carnaille1, F N Pattou, C Oudar
1Departments of General and Endocrine Surgery and Pathology, University Hospital, CHU, 59037 Lille Cedex, France.
World Journal of Surgery
|September 1, 1996
Summary
Incidentally discovered enlarged parathyroid glands during thyroid surgery are mildly hyperfunctioning and may represent early primary hyperparathyroidism (PHPT). Removal is recommended due to unknown significance and evolution.
Area of Science:
- Endocrinology
- Surgical Pathology
- Thyroid Surgery
Background:
- Primary hyperparathyroidism (PHPT) is a common endocrine disorder.
- Incidental parathyroid enlargement can be found during thyroid surgery.
- The clinical significance of incidentally discovered parathyroid tissue is not well understood.
Purpose of the Study:
- To compare incidentally enlarged parathyroid glands with those from patients with proven primary hyperparathyroidism (PHPT).
- To analyze clinical, biochemical, and pathological differences between incidental parathyroid findings and overt PHPT.
Main Methods:
- Retrospective review of 28 patients with incidental parathyroid enlargement and 533 patients with PHPT.
- Comparison of patient demographics, serum calcium and phosphate levels, intact parathyroid hormone (iPTH), parathyroid gland weight, and histological findings.
Main Results:
- Incidental parathyroid lesions were smaller and found in younger patients.
- Biochemical and pathological analyses indicated less hyperfunction in incidental lesions compared to PHPT.
- PTH content was lower in incidentally discovered glands.
Conclusions:
- Incidentally discovered enlarged parathyroid glands exhibit mild hyperfunction.
- These findings may represent an early stage of the disease process leading to overt PHPT.
- Surgical removal of incidentally found enlarged parathyroids during thyroid operations is recommended due to uncertain clinical significance.