Concomitant case of thyroid nodule with parathyroid adenoma - a case report

Authors

  • Ramesh Mahadev Tambat Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India
  • R. Rajashekhar Rao Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India
  • A. V. Kulkarni Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India
  • Rekha V. S. Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India
  • Anchita Bhattacharya Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India

DOI:

https://doi.org/10.18203/2349-2902.isj20210395

Keywords:

Thyroid nodule, Parathyroid adenoma, Thyroidectomy, Parathyroidectomy

Abstract

Coexistence of PHPT in patients with thyroid nodules can complicate patient management if associated with undetected hypercalcemia or unrecognized thyroid cancer. It is an uncommonly diagnosed condition, due to overlapping symptoms in developing countries like India and almost all patient get symptomatic treatment. A 47-year-old female patient presented a history of progressively increasing swelling in the thyroid region associated with continuous dull ache and whose was diagnosed as thyroid nodule with parathyroid adenoma. Thyroidectomy with parathyroidectomy is the preferred modality of treatment for thyroid disorder with additional parathyroid adenoma. The thyroid nodules should be carefully evaluated during the preoperative work-up of a patient with primary hyperparathyroidism. Both MIBI and neck USG should be done in the evaluation of patients undergoing thyroidectomy and parathyroid excision simultaneously to locate the parathyroid adenomas.  

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Author Biographies

Ramesh Mahadev Tambat, Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India

Professor and HOD of Surgery

R. Rajashekhar Rao, Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India

Asistant Professor,Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru.

A. V. Kulkarni, Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India

Associate Professor,Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru.

Rekha V. S., Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India

Senior Resident,Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru.

Anchita Bhattacharya, Sapthagiri Institute of Medical Science and Research Centre, Bengaluru, India

Postgraduate Student ,Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru.

References

Silverberg SJ, Bilezikian JP. Asymptomatic primary hyperparathyroidism: a medical perspective. Surgic Clinic. 2004;84(3):787-801.

Bilezikian JP. Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2018;103(11):3993-4004.

Pradeep P V, Jayashree B, Mishra A and Mishra S K. Systematic review of primary hyperparathyroidism in India: The past, present and future trends. Int J Endocrinol. 2011;921814-7.

Morita SY, Somervell H, Umbricht CB, Dackiw AP, Zeiger MA. Evaluation for concomitant thyroid nodules and primary hyperparathyroidism in patients undergoing parathyroidectomy or thyroidectomy. Surgery. 2008;144(6):862-7.

Murray SE, Sippel RS, Chen H. Incidence of concomitant hyperparathyroidism in patients with thyroid disease requiring surgery. J Surgic Res. 2012;178(1):264-7.

Golden SH, Robinson KA, Saldanha I, Anton B, Ladenson PW. Prevalence and incidence of endocrine and metabolic disorders in the United States: a comprehensive review. J Clinic Endocrinol Metabol. 2009; 94(6):1853-78.

Kissin M, Bakst H. Co-existing myxedema and hyperparathyroidism: case report. J Clinic Endocrinol. 1947;7(2):152-8.

Hellström J. Primary hyperparathyroidism observations in a series of 50 cases. Europ J Endocrinol. 1954;16(1):30-58.

Ogburn PL, Black BM. Primary hyperparathyroidism and papillary adenocarcinoma of the thyroid; report of four cases. In Proceedings of the staff meetings. Mayo Clinic. 1956;31(10):295.

Prinz RA, Barbato AL, Braithwaite SS, Brooks MH, Emanuele MA, Gordon DL, Lawrence AM, Paloyan E. Simultaneous primary hyperparathyroidism and nodular thyroid disease. Surgery. 1982;92(3):454-8.

Lever EG, Refetoff S, Straus FH, Nguyen M, Kaplan EL. Coexisting thyroid and parathyroid disease—are they related? Surgery. 1983; 94(6):893-900.

Strichartz SD, Giuliano AE. The operative management of coexisting thyroid and parathyroid disease. Arch Surg. 1990;125(10):1327-31.

Wagner B, Begic-Karup S, Raber W, Schneider B, Waldhäusl W, Vierhapper H. Prevalence of primary hyperparathyroidism in 13387 patients with thyroid diseases, newly diagnosed by screening of serum calcium. Experiment Clinic Endocrinol Diabet. 1999;107(07):457-61.

Scerrino G, Attard M, Piccolo CL, Melfa GI. The coexistence of primary hyperparathyroidism and thyroid nodules: should the preoperative work-up of the parathyroid and the thyroid diseases be specifically adjusted? II Giornale di chirurgia. 2016:37(3):123.

Bentrem DJ, Angelos P, Talamonti MS, Nayar R. Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism? Thyroid. 2002;12(12):1109-12.

Coakley AJ, Kettle AG, Wells CP, Collins RE. 99Tcm sestamibia new agent for parathyroid imaging. Nucle Medic Communicat. 1989;10(11):791-4.

Ozkan ZG, Unal SN, Kuyumcu S, Sanli Y, Gecer MF, Ozcinar B, Giles YS, Erbil Y. Clinical utility of Tc-99m MIBI SPECT/CT for preoperative localization of parathyroid lesions. Ind J Surg. 2017;79(4):312-8.

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Published

2021-01-29

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Section

Case Reports