The American Journal of Surgery
Volume 185, Issue 1 , Pages 58-60, January 2003

Hyperparathyroidism associated with thyroid pathology

  • Mario Sianesi, M.D.

      Affiliations

    • Institute of General Surgery and Organ Transplant, University of Parma, Via Gramsci, 14, 43100 Parma, Italy
    • Corresponding Author InformationCorresponding author. Tel.: +0039-521-991180; fax: +0039-521-992501.
    • ,
  • Paolo Del Rio, M.D.

      Affiliations

    • Institute of General Surgery and Organ Transplant, University of Parma, Via Gramsci, 14, 43100 Parma, Italy
    • ,
  • Maria Francesca Arcuri, M.D.

      Affiliations

    • Institute of General Surgery and Organ Transplant, University of Parma, Via Gramsci, 14, 43100 Parma, Italy
    • ,
  • Gioacchino Iapichino, M.D.

      Affiliations

    • Institute of General Surgery and Organ Transplant, University of Parma, Via Gramsci, 14, 43100 Parma, Italy
    • ,
  • Robuschi Giuseppe, M.D.

      Affiliations

    • Department of Endocrinology, University of Parma, Parma, Italy

Received 12 October 2001; received in revised form 27 May 2002

Abstract 

Background

The pathological association between thyroid and parathyroid gland disease is here discussed. The multiphase analyzer has revealed a new type of subclinical primary hyperparathyroidism (HPP) and the role of surgery in these cases is not clear.

Methods

This is a prospective study of all cases of thyroid disease in association with parathyroid disease treated surgically in our Institute from July 1999 to June 2001.

Results

Of the 221 thyroidectomies carried out, 29 patients had an elevated preoperative serum level of parathyroid hormone (PTH). An ultrasonography examination was performed on all patients and a preoperative scanning with 99Tc-MIBI on 11 of 29 patients. We examined intraoperatively 19 cases of HPP (14 parathyroid adenoma, 5 hyperplasia). In 10 cases we observed a normal size of the parathyroid gland and we did not perform a parathyroidectomy.

Conclusions

All patients with elevated serum parathyroid hormone and serum calcium levels before thyroidectomy should be considered candidates also for surgery to the parathyroid glands. The pathological association between thyroid and parathyroid gland diseases is not rare. We must conduct an accurate neck exploration in all these cases.

Keywords:  Parathyroidectomy, Primary hyperparathyroidism, Thyroidectomy, Parathyroid hormone

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PII: S0002-9610(02)01121-2

The American Journal of Surgery
Volume 185, Issue 1 , Pages 58-60, January 2003

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