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Results for “Parathyroid Neoplasms”

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PubMedDate not supplied

[Detection of thyroid pathology during surgical exploration of the neck for primary hyperthyroidism].

OBJECTIVE: Our objective was to determine prevalence of incidental thyroid pathology during surgical treatment of primary hyperparathyroidism and to compare sensitivity and specificity of surgical neck exploration with histologic study of resected thyroid gland to confirm unsuspected pathologies. MATERIAL AND METHODS: This was prospective cohort study performed at the Specialty Hospital's Department of Endocrine Surgery at the Mexican Institute of Social Security's (IMSS's) Centro Médico de Occidente in Guadalajara, Jalisco State between 1995 and 2003. All were submitted to bilateral neck exploration under general anesthesia. According to the surgeon's criteria, any suspected thyroid anomaly was resected for transoperative frozen sections as well as definite histopathologic study. RESULTS: Preoperatively from a total of 44 cases of hyperparathyroidism, only four cases with thyroid anomalies were detected with neck ultrasound and/or computer tomography (CT) scan; additionally, 13 patients had thyroid anomalies found during neck exploration according to surgeon criteria. All were biopsied. Final study revealed thyroid disease in 16 cases; three had well-differentiated thyroid carcinoma and the remaining 13 patients had different benign entities. In one case, the thyroid specimen was considered normal. Sensitivity and specificity of surgeon criteria were 100 and 96%, respectively, to establish thyroid disease during neck exploration for another purpose. CONCLUSIONS: Association of hyperparathyroidism and benign and malignant thyroid disease is a common phenomenon. Independently of the ability of preoperative imaging procedures to detect unsuspected findings, we suggest exploration neck bilaterally and resection of any suspicious lesion.

Adenocarcinoma, Follicular↗
PubMed1991

[Coincidence of non-medullary thyroid cancer and hyperparathyroidism].

Hyperparathyroidism (HPT) and non-medullary thyroid carcinoma are not related by a common embryologic origin. In a 5-years period (1985-1989) 163 patients were operated for HPT at our hospital. Of these, 54 patients had concurrent thyroid disease, which was operated simultaneously. In 6 cases, thyroid carcinoma was found, e.g. 3.7% of all patients. This prevalence compares well to reports of different authors in the literature. The most probable explanation is the early diagnosis of asymptomatic occult papillary carcinomas; this was true in 4 of our 6 patients with thyroid malignancy.

Adenoma↗
PubMed1990

[Coincidence of hyperparathyroidism and thyroid gland cancer].

127 patients, operated for hyperparathyroidism in a 4-years period (1986-1989) were analyzed retrospectively, regarding concurrent thyroid disease. In 42 patients (33%) thyroid resection was performed simultaneously. Of these, in five cases (4%), thyroid malignancy was discovered: there was one follicular carcinoma, one multilocular papillary tumor and three well differentiated small papillary carcinomas (less than 1.5 cm diameter). This prevalence of thyroid tumors is comparable to the results of different authors (2.5-8.5% in the literature). We conclude that preoperative examination should include the thyroid gland before parathyreotoid exploration.

Adenoma↗
PubMed1990

Bone tumors.

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Adenoma↗
PubMed1985

Multiple endocrine neoplasia type I.

During the 13-year period 1970-1983 only 7 cases of multiple endocrine neoplasia type I (MEN I) were seen at Groote Schuur Hospital, suggesting that the associated gene is rare in this area. Only 1 of these patients was black. Endocrine associations were as follows: hyperparathyroidism--6 cases, pituitary hypersecretion--6 cases (3 each involving growth hormone and prolactin), and pancreatic hypersecretion--3 cases (2 of gastrinoma and 1 of insulinoma). The presenting features were predictably diverse and depended on the component which manifested first. There was little difficulty in reaching a diagnosis on routine investigation. All patients with hyperparathyroidism underwent a 3 1/2-gland parathyroidectomy as the first treatment procedure, normocalcaemia being achieved in 5 cases, but persistent hypercalcaemia in the 6th suggested a supernumerary gland. A pituitary adenoma was removed in 4 cases, but persistent prolactinaemia necessitated bromocriptine therapy in 3. Successful distal pancreatectomy was undertaken in a patient with insulinoma and a patient with gastrinoma, and a further patient with gastrinoma awaits surgery. The overall prognosis in cases of MEN I appears to depend on the most aggressive component, often the pancreatic lesion; our patients have run a surprisingly benign course with only 1 late death, from hypertensive heart disease.

Adult↗
PubMedDate not supplied

Coexistent disease as a complicating factor in the fine needle aspiration diagnosis of papillary carcinoma of the thyroid.

The occasional coexistence of papillary carcinoma of the thyroid with nodular goiter or hyperparathyroidism may in some cases result in a significant discrepancy between the clinical impression and the fine needle aspiration (FNA) biopsy diagnosis, leading to the suspicion that a false-positive FNA diagnosis was obtained. Two such cases are presented in which consultation between the cytopathologist and the surgeon was helpful in achieving a correct diagnosis and ensuring proper therapy. Awareness of these variations in the clinical presentation of papillary carcinoma of the thyroid will aid the cytopathologist in the resolution of such apparent discrepancies.

Adenoma↗