CONCOMITANT THYROID DISEASES IN PRIMARY HYPERPARATHYROIDISM PATIENTS SUBMITTED TO PARATHYROIDECTOMY

AUTHORS:
H. Markogiannakis (Athens, Greece) , A. Hatzicharalambous (Athens, Greece) , M. Kalamatianou (Athens, Greece) , A.S. Zambopoulou (Athens, Greece) , T. Hatzitheodorou (Athens, Greece) , E. Kitsou (Athens, Greece) , N. Intzes (Athens, Greece) , I. Manouras (Athens, Greece) , K.G. Toutouzas (Athens, Greece) , D. Theodorou (Athens, Greece)
Background:
Our objective was the analysis of concomitant thyroid diseases in primary hyperparathyroidism cases undergoing parathyroid surgery during the last 14 years.
Methods:
Prospective study of all patients with primary hyperparathyroidism submitted to parathyroidectomy in our department from 1/1/2010 until 30/09/2023.
Results:
A total of 342 cases were included in the study. Female patients (81.9%) comprised the majority of them (mean age: 56.6 years, range: 16-80 years). Diagnosis was solitary parathyroid adenoma in 93%, primary hyperplasia 5%, double adenoma 1.7% and parathyroid carcinoma in 0.3%. A significant proportion of the study patients (n=146, 42.7%) presented concomitant thyroid disorders. Preoperative thyroid disease diagnosis was multinodular goiter in 31.6%, Hashimoto's thyroiditis 14.6%, toxic multinodular goiter 1.5%, papillary cancer 1.2%, solitary nodule 0.9%, Graves' disease 0.3% and medullary carcinoma in 0.3%. In addition to parathyroid surgery, 14.6% underwent a total thyroidectomy and 3.5% hemithyroidectomy. Histopathology examination reported papillary thyroid cancer in 5.3% of the total study group, representing 29% of the thyroidectomy cases.
Conclusions:
Primary hyperparathyroidism patients waiting for parathyroidectomy often suffer from several concomitant thyroid diseases highlighting the importance of preoperative evaluation with thyroid function tests and neck ultrasound.