Primer Hiperparatiroidili Hastalarda Nodüler Guatr ve Papiller Tiroid Kanseri Birlikteliğinin Değerlendirilmesi

Abstract

Amaç: Primer hiperparatiroidi ve diferansiye tiroid karsinomu en sık görülen endokrinolojik hastalıklardır. İlk tanımlanmış olduğu 1950’li yıllardan bu yana primer hiperparatiroidili hastalarda nodüler guatr ve diferansiye tiroid karsinomu varlığı birçok çalışmada incelenmiş ve kanser insidansında bir artış olduğu saptanmıştır. Bu çalışmada, primer hiperparatiroidili hastalardaki nodüler guatr ve diferansiye tiroid kanseri birlikteliğinin araştırılması amaçlandı. Gereç ve Yöntemler: Bu çalışmaya hastanemizde 2012 ve 2015 yılları arasında paratiroid cerrahisi yapılmış olan toplam 172 hasta dahil edildi. Hastaların demografik, klinik ve cerrahi verileri geriye dönük olarak incelendi. Bulgular: Hastaların yaş ortalaması 54,3±11,3 yıl olup %85,5’i (n=147) kadın idi. Hastaların preoperatif değerlendirmesinde %61,0 (n=105) oranında nodüler guatr izlenmiştir. Hastaların 125’ine (%72,7) sadece paratiroidektomi uygulanırken 32’sine (%18,6) eş zamanlı total tiroidektomi ve 15’ine (%8,7) ise eş zamanlı lobektomi uygulanmıştır. Histopatolojik olarak değerlendirilen paratiroid dokularının %94,8’i (n=163) adenom olarak yorumlanırken, %2,9’u (n=5) paratiroid hiperplazisi ve %2,3’ü (n=4) paratiroid karsinomu olarak yorumlanmıştır. Histopatolojik olarak tiroid karsinomu saptanan (n=30) hastalar ile benign saptanan (n=17) hastalar klinik ve laboratuvar özellikleri yönünden karşılaştırılmış olup hiçbir parametrede anlamlı bir farklılık izlenmemiştir. Sonuç: Primer hiperparatiroidili hastalarda tiroid nodülaritesinde anlamlı bir artış olmamakla birlikte, bu çalışmada literatürle uyumlu şekilde diferansiye tiroid kanseri insidansında anlamlı bir artış saptanmıştır. Bu bulgu da bu hasta grubunda preoperatif olarak yapılan tiroid dokusu değerlendirmesinin önemini vurgulamaktadır.

Keywords

• Primer hiperparatiroidi
• nodüler guatr
• tiroid kanseri

Evaluation of Nodular Goiter and Papillary Thyroid Cancer Coincidence in Patients with Primary Hyperparathyroidism

Abstract

Aim: Primary hyperparathyroidism and differentiated thyroid carcinoma are the most common endocrinological diseases. Since its first definition in the 1950s, nodular goiter and differentiated thyroid carcinoma in patients with primary hyperparathyroidism have been examined in many studies and an increase in cancer incidence has been found. In this study, we aimed to investigate the co-incidence of nodular goiter and differentiated thyroid cancer in patients with primary hyperparathyroidism. Material and Methods: One hundred seventy-two patients who underwent parathyroid surgery in our hospital between 2012 and 2015 were included in this study. Demographic, clinic, and surgical data of the patients were reviewed retrospectively. Results: The mean age of the patients was 54.3±11.3 years and 85.5% (n=147) of them were female. Nodular goiter was observed at a rate of 61.0% (n=105) in preoperative evaluation. Parathyroidectomy was performed in 125 (72.7%) and simultaneous total thyroidectomy was performed in 32 (18.6%) and lobectomy in 15 (8.7%) of the patients. Histopathologically, 94.8% (n=163) were interpreted as adenoma, 2.9% (n=5) as parathyroid hyperplasia, and 2.3% (n=4) as parathyroid carcinoma. Patients with papillary thyroid carcinoma (n=30) and benign (n=17) histopathologically were compared in terms of clinical and laboratory characteristics, and no significant difference was observed in any parameter. Conclusion: There was no significant increase in thyroid nodularity, but a significant increase was found in differentiated thyroid carcinoma incidence in patients with primary hyperparathyroidism in this study in accordance with the literature. This finding highlights the importance of preoperative thyroid evaluation in this patient group.

Keywords

• Primary hyperparathyroidism
• nodular goiter
• thyroid cancer

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