Coexistence of primary hyperparathyroidism and thyroid disease

Primary hyperparathyroidism (HPT) and thyroid disease are both relatively c ommon diseases, which can coexist in the same patient. However, mere coinci dence does not seem to be a satisfactory explanation for this association. Some factors like prior exposure to radiation may play a role in the associ ation. The aim of this study was to determine the frequency of thyroid dise ase associated with HPT in 54 consecutive patients who underwent parathyroi dectomy in our center from January 1990 to December 1997. Twenty-eight (52% ) patients had thyroid disease associated to HPT. The patients had a mean a ge of 61+/-13 yr; they were predominantly postmenopausal women. Thyroid dis ease was detected preoperatively in 20 (71%) patients and during the surgic al procedure in 8 (29%). Two patients had previous radiation exposure; one of them with papillary carcinoma of the thyroid. Two patients had hypothyro idism. Ultrasonography was performed in the majority of patients in their p reoperative evaluation. A multinodular goiter was seen to be the most frequ ent finding (76%). In addition to parathyroidectomy, 23 (82%) patients were also thyroidectomized. In conclusion, patients with HPT showed a high prev alence of thyroid disease, especially in postmenopausal women. Unsuspected thyroid lesions were found with sufficient frequency to warrant careful pre operative and intraoperative evaluation of both glands, in order to obviate reoperation. in experienced hands, combined surgery can be safely performe d. Cervical ultrasonography is useful in the preoperative detection of nodu lar thyroid disease in these patients. (C) 1999, Editrice Kurtis.