The impact of office neck ultrasonography on reducing unnecessary thyroid surgery in patients undergoing parathyroidectomy

Kresimira Milas, Angela Mensah, Mohammed Alghoul, Eren Berber, Antonia Stephen, Allan Siperstein, Collin J. Weber

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Background: Some have suggested that thyroid disease is even more prevalent among patients with hyperparathyroidism (HPT) than in the general population. We sought to define the incidence and optimal management strategies of thyroid disease in patients undergoing surgery for HPT. Methods: Clinical characteristics were reviewed for 1200 consecutive HPT patients treated at two endocrine surgery referral centers from 1992-2003. Both centers practice bilateral neck exploration, and one routinely obtains preoperative neck ultrasound (US) performed by surgeons. Results: Forty percent (477/1195) of HPT patients had coexisting thyroid disease, whether identified at parathyroidectomy (39%; 327/845) or by US (43%; 150/350). Colloid nodules/goiters accounted for nearly half of thyroid pathology, followed by follicular adenomas, papillary cancer, thyroiditis, and intrathyroidal parathyroids. Thyroid malignancy was found in 4.6% of HPT patients versus less than 1% in autopsy reports. Thyroid pathology was similar among single adenomas, multigland, and renal HPT. Unexpected thyroid disease first encountered at parathyroidectomy required partial or total thyroidectomy in 30% (257/845). US-detected thyroid nodules prompted fine-needle biopsy in 20%, which was cost effective in limiting concomitant thyroid surgery to fewer patients (6%; 21/350). Overall low incidence (

Original languageEnglish (US)
Pages (from-to)1055-1059
Number of pages5
JournalThyroid
Volume15
Issue number9
DOIs
Publication statusPublished - Sep 2005
Externally publishedYes

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ASJC Scopus subject areas

  • Endocrinology

Cite this

Milas, K., Mensah, A., Alghoul, M., Berber, E., Stephen, A., Siperstein, A., & Weber, C. J. (2005). The impact of office neck ultrasonography on reducing unnecessary thyroid surgery in patients undergoing parathyroidectomy. Thyroid, 15(9), 1055-1059. https://doi.org/10.1089/thy.2005.15.1055