Ghorra Claude, Rizk Habib, Abi Hachem Ralph, Tannoury Jenny, Abboud Bassam
Saint-Joseph university, faculty of medicine, Hôtel-Dieu de France hospital, department of pathology, Beirut, Lebanon.
Presse Med. 2012 Jun;41(6 Pt 1):e265-71. doi: 10.1016/j.lpm.2011.12.016. Epub 2012 Mar 28.
The objective was to evaluate the association of well-differentiated thyroid carcinoma and parathyroid pathology.
The medical records of 14 patients with concomitant pathologies were retrospectively reviewed.
Parathyroidectomies (1.3%) and thyroidectomies (3.5%) performed for well-differentiated thyroid carcinoma resulted in the diagnosis of concomitant pathologies. Five patients had a primary hyperparathyroidism (PHPT) and nine were operated for thyroidectomy with intraoperative finding of an enlarged parathyroid gland. Patients (64%) were normocalcemic preoperatively. Thirteen had papillary carcinoma. Fifty percent of patients had multiple foci of papillary microcarcinoma. Twenty-nine percent of patients had parathyroid hyperplasia. All patients with preoperative hypercalcemia normalized their serum calcium. During follow-up, thyroglobuline, calcium serum values and cervical ultrasound showed no evidence of recurrence of the diseases.
These observations stress the importance of pre and intraoperative evaluation to detect overt thyroid and parathyroid pathology before performing a parathyroidectomy for hyperparathyroidism or a thyroidectomy for a well-differentiated thyroid carcinoma.
评估高分化甲状腺癌与甲状旁腺病理之间的关联。
回顾性分析14例合并其他病变患者的病历。
因高分化甲状腺癌行甲状旁腺切除术（1.3%）和甲状腺切除术（3.5%）时诊断出合并其他病变。5例患者患有原发性甲状旁腺功能亢进症（PHPT），9例因术中发现甲状旁腺肿大而接受甲状腺切除术。患者术前血钙正常（64%）。13例为乳头状癌。50%的患者有多个乳头状微小癌灶。29%的患者有甲状旁腺增生。所有术前高钙血症患者的血清钙均恢复正常。随访期间，甲状腺球蛋白、血清钙值和颈部超声检查均未发现疾病复发迹象。
这些观察结果强调了术前和术中评估对于在因甲状旁腺功能亢进症行甲状旁腺切除术或因高分化甲状腺癌行甲状腺切除术之前检测明显的甲状腺和甲状旁腺病变的重要性。
