Faculty Collaboration Database

Primary hyperparathyroidism with a history of head and neck irradiation: the consequences of associated thyroid tumors. Surgery 2011 Oct;150(4):869-77

Date

10/18/2011

Pubmed ID

22000202

DOI

10.1016/j.surg.2011.07.046

Scopus ID

2-s2.0-80054119224 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

BACKGROUND: Information on thyroid tumors is scant in patients with primary hyperparathyroidism (HPT) and history of head and neck irradiation. The study objective was to investigate thyroid pathology in primary HPT patients with irradiation history presenting for parathyroidectomy.

METHODS: A prospective database of 1,020 parathyroidectomy patients was analyzed. 916 consecutive HPT patients were identified. History of radiation, neck ultrasound results, thyroid operations, and pathology was assessed. Patients with radiation history were compared to those with no radiation.

RESULTS: Of the 916 HPT patients, 49 (5%) had a history of radiation and were more likely to have nodular thyroid disease (95% vs 52%), undergone a prior thyroidectomy (29% vs 4%), or had concurrent thyroidectomy (49% vs 26%). Nine of 49 (24%) had thyroid cancer. Of the 867 patients with no history of radiation, 259 underwent thyroid resection (32 prior and 227 concurrent) and 32 (12%) had thyroid cancer.

CONCLUSION: Primary HPT patients with head and neck irradiation presenting for parathyroidectomy had marked increase in nodular thyroid disease: nearly 1 in 2 had concurrent thyroidectomy, and nearly 1 in 4 had thyroid carcinoma. High resolution ultrasound prior to parathyroidectomy detects associated thyroid pathology and allows the surgeon to plan the extent of thyroid resection.

Author List

Wilson SD, Doffek KM, Wang TS, Krzywda EA, Evans DB, Yen TW

Authors

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Biopsy, Fine-Needle
Databases, Factual
Female
Head
Humans
Hyperparathyroidism, Primary
Male
Middle Aged
Neck
Neoplasms, Radiation-Induced
Parathyroidectomy
Prospective Studies
Radiation Injuries
Radionuclide Imaging
Radiopharmaceuticals
Technetium Tc 99m Sestamibi
Thyroid Neoplasms
Thyroidectomy
Ultrasonography