Ann Surg Treat Res.  2023 Nov;105(5):290-296. 10.4174/astr.2023.105.5.290.

Predicting coexisting thyroid cancer with primary hyperparathyroidism in an endemic region of multinodular goiter: evaluating the effectiveness of preoperative inflammatory markers

• Balbaloglu H
• Tasdoven I
• Buyukuysal MC
• Karadeniz E
• Comert M
• Cakmak GK

• KMID: 2547534
• DOI: http://doi.org/10.4174/astr.2023.105.5.290

Abstract

Purpose
The aim is to examine the efficacy of inflammatory indicators to predict thyroid cancer in patients with primary hyperparathyroidism (PHPT) in an endemic region of nodular goiter.
Methods
The prospective database was reviewed to identify patients operated on with the diagnosis of PHPT and thyroid disease between April 2015 and June 2021. Permanent pathologic reports were used as the gold standard for diagnosis. Detailed imaging data with peripheral blood inflammation indices were analyzed to assess their predictive values for concomitant PHPT with thyroid cancer. Postoperative complications and the duration of hospitalization were also reviewed.
Results
Thyroid malignancy accompanying PHPT was found in 13 patients (26.0%) out of 50 who had concurrent surgery. The analysis regarding inflammatory indexes revealed nothing significant between thyroid cancer and preoperative blood biochemistry (P > 0.05). In the concurrent surgery group, recurrent laryngeal nerve injury was observed in 1 patient (2.0%) and the mean hospital stay was longer.
Conclusion
In endemic regions of nodular thyroid disease, thyroid cancer might accompany PHPT. The value of inflammatory indexes to predict thyroid malignancy in PHPT is controversial and should not be employed in the surgical decision-making process.

Keyword

Primary hyperparathyroidism; Thyroid neoplasms; Neck ultrasound; Sestamibi scan; Inflammatory indices

Figure

• 

  Fig. 1 Preoperative neck ultrasound. Black arrow, thyroid adenoma; white arrow, parathyroid adenoma.

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