PRİMER HİPERPARATİROİDİ NEDENİYLE OPERE EDİLEN VAKALARDA EŞLİK EDEN TİROİD PATOLOJİLERİNİN DEĞERLENDİRİLMESİ

Amaç: Primer hiperparatiroidi (PHPT) nedeniyle paratirodektomi yapılan hastalarda eşlik edentiroid patolojilerinin değerlendirilmesi amaçlandı.Gereç ve Yöntem: Bu retrospektif çalışmaya 2006-2012 yılları arasında PHPT tanısı nedeniyleparatiroidektomi yapılan hastalar dahil edildi. Operasyon öncesi ve sonrası hastalarınbiyokimyasal ve hormonal tetkikleri, preoperatif görüntüleme tetkiklerinin sonuçları kaydedildi.Bulgular: Çalışmaya dahil edilen PHPT hastaların 86’sı kadın, 12’si erkekti. Hastalarınpreoperatif serum kalsiyumu ortalama 12.25 ± 1.48 mg/dL (8.5-10.1 mg/dL), paratiroit hormon(PTH) 425.09 ± 440.47 pg/mL (11-65 pg/mL) bulundu. Doksan sekiz hastanın 93’ünün tiroidultrason kayıtlarına ulaşıldı. Bu hastaların 26’sında (%28) tiroid ultrasonu normal, 18’inde(%19.4) soliter nodül, 43’ünde (%46.2) multinodüler guatr, 4’ünde (%4.3) tiroidit (nodülsüz),2’sinde (%2.2) soliter nodül ve tiroidit görünümü birlikte tespit edildi. Genel olarak hastaların%72’sinde tiroid patolojisi mevcuttu. Hastaların %45.2’sinde ultrasonda ve %72.7’sindeparatiroit sintigrafisinde paratiroit adenomu tespit edildi. Doksan sekiz hastanın 54’üne (%65.1)paratiroidektomi ile birlikte tiroidektomi de yapıldı. Yedi (%7.1) hastada papiller tiroid kanseri,30 hastada (%30.6) benign multinodüler guatr, 8 hastada (%8.2) benign soliter nodül, 2 hastada(%2) lenfositik tiroidit ve 7 hastada (%7.1) normal tiroid dokusu tespit edildi. Sonuç: Tiroid hastalıklarının PHPT ile birlikteliği sık görülebilmektedir. Bu nedenleparatiroidektominin minimal invaziv yöntemle yapılmasına karar vermeden önce hastalarmutlaka tiroid patolojisi açısından değerlendirilmelidir

Anahtar Kelimeler:

Primer hiperparatiroidi, paratiroidektomi, tiroid kanseri

Assessment of Thyroid Disease in Patients Who Underwent Surgical Treatment of Primary Hyperparathyroidism

Purpose: In this study we aimed to evaluate thyroid pathologies in patients with primaryhyperparathyroidism who underwent surgery for parathyroidectomy.Methods: Patients who underwent parathyroidectomy for primary hyperparathyroidism betweenthe years of 2006-2012 were included in this retrospective study. Before and after surgery,hormonal and biochemical examinations of the patients and results of preoperative imagingstudies were recorded.Results: Of the patients included in the study, 86 were female and 12 were male. Preoperativemean serum calcium level was 12.25 ± 1.48 mg/dL (normal range 8.5-10.1 mg/dL), meanparathyroid hormone (PTH) level was 425.09 ± 440.47 pg/mL (normal range 11-65 pg/mL).The thyroid ultrasound records of 93 patients were available. Of these patients, 26 (28%) hadnormal ultrasound, 18 (19.4%) had solitary nodule, 43 (46.2%) had multinodular goiter and 4(4.3%) had thyroiditis (without nodule) and 2 (% 2.2) had solitary nodule with thyroiditis.Adenoma was detected by ultrasonography in 45.2 % of patients, and by scintigraphy in 72.7of patients. Parathyroidectomy and thyroidectomy were performed at the same time in 54 of 98patients (65.1%). Of these patients Seven (7.1%) had papillary thyroid cancer, 30 (30.6%) hadbenign multinodular goiter, 8 patients (8.2%) had benign solitary nodule, 2 patients (2%) hadlymphocytic thyroiditis, and 7 (7.1%) had normal thyroid tissue.Conclusion: Thyroid diseases are frequently encountered with primary hyperparathyroidism.Therefore, before performing parathyroidectomy with minimally invasive procedure, patientsmust be evaluated for thyroid disorders

Keywords:

Primary hyperparathyroidism, parathyroid surgery, thyroid carcinoma,

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