Coexistent thyroid pathologies and high rate of papillary cancer in patients with primary hyperparathyroidism:: Controversies about minimal invasive parathyroid surgery
Coexistent thyroid pathologies and high rate of papillary cancer in patients with primary hyperparathyroidism:: Controversies about minimal invasive parathyroid surgery
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DOI：
10.1080/00015458.2004.11679616
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发表时间：
2004-09-01
影响因子：
0.8
通讯作者：
Öztürk, M
中科院分区：
文献类型：
--
作者：
Kösem, M;Algün, E;Öztürk, M
甲状腺癌和与原发性甲状旁腺功能亢进症（PHPT）相关的良性甲状腺疾病可能会给 PHPT 的诊断、定位和治疗带来困难。在这项研究中，我们分析了 51 名在 1999 年至 2002 年间接受颈部探查并诊断为 PHPT 的患者的共存甲状腺病变。 513 例因结节性甲状腺疾病接受甲状腺切除术但组织病理学检查未发现甲状旁腺病理的患者作为对照。 PHPT 患者中有 43 例（84.3%）同时存在甲状腺病变。 9 名患者 (17.6%) 患有甲状腺乳头状癌。 9 名患者（17.6%）患有淋巴细胞性甲状腺炎，2 名患者（3.9%）患有良性甲状腺腺瘤，24 名患者（47%）患有结节性增生。一名患者 (2%) 出现甲状旁腺癌甲状腺内转移。一名患者同时患有淋巴细胞性甲状腺炎和多灶性乳头状癌。两例甲状腺腺瘤病例之一为 Hurthle 细胞型。在对照组中，只有 28 名患者 (5.5%) 患有甲状腺恶性肿瘤（27 名乳头状癌和 1 名滤泡状癌）。总之，合并甲状腺病变在 PHPT 患者中非常普遍，术前和术中应进行甲状腺检查，以避免忽视重要的甲状腺病变。
Thyroid carcinoma and benign thyroid diseases associated with primary hyperparathyroidism (PHPT) may cause difficulties in the diagnosis, localization and therapy of PHPT. In this study, we analysed coexistent thyroid pathologies in 51 patients who underwent neck exploration with a diagnosis of PHPT between 1999-2002. Five hundred thirteen patients who underwent thyroidectomy for nodular thyroid disease without a parathyroid pathology in histopathological examination served as controls. In patients with PHPT there were 43 cases (84.3%) of coexistent thyroid pathology. Nine patients (17.6%) had coexistent papillary thyroid cancer. Nine patients (17.6%) had lymphocytic thyroiditis, two (3.9%) had benign thyroid adenoma and 24 (47%) had nodular hyperplasia. In one patient (2%), there was intrathyroidal metastasis from a parathyroid cancer. One patient had coexistent lymphocytic thyroiditis and multi-focal papillary cancer. One of the two cases with thyroid adenomas was Hurthle cell type. In the control group only 28 patients (5.5%) had thyroid malignancy (27 papillary cancer and one follicular cancer). In conclusion, the coexistent thyroid pathologies are highly prevalent in patients with PHPT and pre- and intra-operative thyroid examination should be performed to avoid overlooking important thyroid pathologies.