Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics
Abstract Background The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s12893-019-0556-y |
| _version_ | 1811220320755908608 |
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| author | Cristina Preda Dumitru Branisteanu Ioana Armasu Radu Danila Cristian Velicescu Delia Ciobanu Adrian Covic Alexandru Grigorovici |
| author_facet | Cristina Preda Dumitru Branisteanu Ioana Armasu Radu Danila Cristian Velicescu Delia Ciobanu Adrian Covic Alexandru Grigorovici |
| author_sort | Cristina Preda |
| collection | DOAJ |
| description | Abstract Background The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported. The aim of the study was to evaluate the rate of thyroid cancer in patients operated for either primary (PHPT) or secondary hyperparathyroidism (SHPT). Methods Our retrospective study included PHPT and SHPT patients submitted to parathyroidectomy and, when indicated, concomitant thyroid surgery between 2010 and 2017. Results Parathyroidectomy was performed in 217 patients: 140 (64.5%) for PHPT and 77 (35.5%) for SHPT. Concomitant thyroid surgery was performed in 75 patients with PHPT (53.6%), and 19 papillary thyroid carcinomas (PTC) were found, accounting for 13.6% from all cases with PHPT and 25.3% from PHPT cases with concomitant thyroid surgery. Thirty-one of operated SHPT patients (40.3%) also underwent thyroid surgery and 9 PTC cases were diagnosed (11.7% of all SHPT patients and 29% of patients with concomitant thyroid surgery). We found differences between PHPT and SHPT patients (p < 0.001) with respect to age (54.6 ± 13y versus 48.8 ± 12y), female-to-male ratio (8:1 versus ~ 1:1), surgical technique (single gland parathyroidectomy in 82.8% PHPT cases; versus subtotal parathyroidectomy in 85.7% SHPT cases) and presurgical PTH (357.51 ± 38.11 pg/ml versus 1020 ± 161.38 pg/ml). Morphopathological particularities, TNM classification and multifocality incidence of PTC were similar in the two groups. All PTC from patients with SHPT were thyroid microcarcinomas (TMC, i.e. tumors with a diameter smaller than 1 cm), whereas seven out of the 19 cases with PTC and PHPT were larger than 1 cm. Conclusions PTC was frequently and similarly associated with both PHPT and SHPT irrespective of presurgical PTH levels. Thyroid tumors above 1 cm were found only in patients with PHPT. Investigators should focus also on associated thyroid nodular pathology in patients with PHPT. |
| first_indexed | 2024-04-12T07:39:41Z |
| format | Article |
| id | doaj.art-0d27dfc8123c41dca306c429d7211d4e |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-12T07:39:41Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-0d27dfc8123c41dca306c429d7211d4e2022-12-22T03:41:51ZengBMCBMC Surgery1471-24822019-07-0119111010.1186/s12893-019-0556-yCoexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristicsCristina Preda0Dumitru Branisteanu1Ioana Armasu2Radu Danila3Cristian Velicescu4Delia Ciobanu5Adrian Covic6Alexandru Grigorovici7Faculty of Medicine, Department of Endocrinology, “Gr igore T Popa” University of Medicine and PharmacyFaculty of Medicine, Department of Endocrinology, “Gr igore T Popa” University of Medicine and PharmacyDepartment of Morphofunctional Sciences, “Grigore T. Popa” University of MedicineFaculty of Medicine, Department of Surgery, “Grigore T Popa” University of Medicine and PharmacyFaculty of Medicine, Department of Surgery, “Grigore T Popa” University of Medicine and PharmacyFaculty of Medicine, Department of Morphopathology, “Grigore T Popa” University of Medicine and PharmacyFaculty of Medicine, Department of Nephrology, “Grigore T Popa” University of Medicine and PharmacyFaculty of Medicine, Department of Surgery, “Grigore T Popa” University of Medicine and PharmacyAbstract Background The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported. The aim of the study was to evaluate the rate of thyroid cancer in patients operated for either primary (PHPT) or secondary hyperparathyroidism (SHPT). Methods Our retrospective study included PHPT and SHPT patients submitted to parathyroidectomy and, when indicated, concomitant thyroid surgery between 2010 and 2017. Results Parathyroidectomy was performed in 217 patients: 140 (64.5%) for PHPT and 77 (35.5%) for SHPT. Concomitant thyroid surgery was performed in 75 patients with PHPT (53.6%), and 19 papillary thyroid carcinomas (PTC) were found, accounting for 13.6% from all cases with PHPT and 25.3% from PHPT cases with concomitant thyroid surgery. Thirty-one of operated SHPT patients (40.3%) also underwent thyroid surgery and 9 PTC cases were diagnosed (11.7% of all SHPT patients and 29% of patients with concomitant thyroid surgery). We found differences between PHPT and SHPT patients (p < 0.001) with respect to age (54.6 ± 13y versus 48.8 ± 12y), female-to-male ratio (8:1 versus ~ 1:1), surgical technique (single gland parathyroidectomy in 82.8% PHPT cases; versus subtotal parathyroidectomy in 85.7% SHPT cases) and presurgical PTH (357.51 ± 38.11 pg/ml versus 1020 ± 161.38 pg/ml). Morphopathological particularities, TNM classification and multifocality incidence of PTC were similar in the two groups. All PTC from patients with SHPT were thyroid microcarcinomas (TMC, i.e. tumors with a diameter smaller than 1 cm), whereas seven out of the 19 cases with PTC and PHPT were larger than 1 cm. Conclusions PTC was frequently and similarly associated with both PHPT and SHPT irrespective of presurgical PTH levels. Thyroid tumors above 1 cm were found only in patients with PHPT. Investigators should focus also on associated thyroid nodular pathology in patients with PHPT.http://link.springer.com/article/10.1186/s12893-019-0556-yPrimary hyperparathyroidismSecondary hyperparathyroidismPapillary thyroid carcinomaAssociation |
| spellingShingle | Cristina Preda Dumitru Branisteanu Ioana Armasu Radu Danila Cristian Velicescu Delia Ciobanu Adrian Covic Alexandru Grigorovici Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics BMC Surgery Primary hyperparathyroidism Secondary hyperparathyroidism Papillary thyroid carcinoma Association |
| title | Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics |
| title_full | Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics |
| title_fullStr | Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics |
| title_full_unstemmed | Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics |
| title_short | Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics |
| title_sort | coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism same incidence different characteristics |
| topic | Primary hyperparathyroidism Secondary hyperparathyroidism Papillary thyroid carcinoma Association |
| url | http://link.springer.com/article/10.1186/s12893-019-0556-y |
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