PMID- 30608029
OWN - NLM
STAT- MEDLINE
DCOM- 20200212
LR  - 20200212
IS  - 1557-9077 (Electronic)
IS  - 1050-7256 (Linking)
VI  - 29
IP  - 2
DP  - 2019 Feb
TI  - Concomitant Thyroid Cancer in Patients with Multiple Endocrine Neoplasia Type 1 
      Undergoing Surgery for Primary Hyperparathyroidism.
PG  - 252-257
LID - 10.1089/thy.2017.0675 [doi]
AB  - BACKGROUND: Compared to those with sporadic primary hyperparathyroidism (SPHP), 
      multiple endocrine neoplasia type 1 (MEN1) patients with primary 
      hyperparathyroidism (MPHP) typically require more extensive dissection and have 
      higher recurrence rates. Little is known about the risk of concomitant thyroid 
      cancer in either setting. This study aimed to determine the rates and 
      characteristics of thyroid cancer for MPHP versus SPHP patients undergoing 
      parathyroidectomy. METHODS: Patients with MPHP (diagnosed by clinical and/or 
      genetic criteria) or SPHP who had initial or reoperative parathyroid exploration 
      from 1967 to 2014 were identified via a prospective database. The thyroid 
      cancer-specific data for MPHP patients (n = 29) were compared to a selected 2:1 
      age- and sex-matched SPHP cohort (n = 58) who all had concurrent thyroidectomy 
      for any reason. Clinically significant thyroid cancer was defined as >1 cm in 
      diameter. RESULTS: In the MPHP group, 24/29 (83%) thyroidectomies were 
      preoperatively unplanned versus 20/58 (34%) in the SPHP matched cohort 
      (p < 0.01), and in this setting there was no difference in the rate of histologic 
      thyroid cancer (3/24 [13%] vs. 5/20 [25%], p = 0.44). Histologic thyroid cancer 
      was identified in 8/29 (28%) MPHP versus 27/58 (47%) SPHP patients (p = 0.11). 
      Despite observed differences in the time period and extent of thyroidectomy, MPHP 
      patients did not have an increased likelihood of thyroid cancer (surgery before 
      2005: odds ratio [OR] = 2.57, p = 0.09; total thyroidectomy: OR = 5.47, p < 0.01; 
      MPHP: OR = 1.14, p = 0.83). All MPHP thyroid cancers were characterized as 
      conventional papillary thyroid cancer (PTC), while thyroid cancers in SPHP 
      patients included both PTC (66%) and follicular-variant PTC (34%). No MPHP 
      patient had clinically significant thyroid cancer compared to an incidence of 
      15/58 (26%) in SPHP patients (p < 0.01). CONCLUSIONS: Although patients with MEN1 
      have a substantial incidence of thyroid cancer (28%) and undergo more unplanned 
      thyroidectomies during parathyroidectomy than do patients with SPHP, clinically 
      significant thyroid cancer is proportionally uncommon.
FAU - Hill, Katherine A
AU  - Hill KA
AD  - 1 Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
FAU - Yip, Linwah
AU  - Yip L
AD  - 2 Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, 
      Pittsburgh, Pennsylvania.
FAU - Carty, Sally E
AU  - Carty SE
AD  - 2 Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, 
      Pittsburgh, Pennsylvania.
FAU - McCoy, Kelly L
AU  - McCoy KL
AD  - 2 Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, 
      Pittsburgh, Pennsylvania.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Thyroid
JT  - Thyroid : official journal of the American Thyroid Association
JID - 9104317
SB  - IM
MH  - Adult
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism, Primary/*complications/*surgery
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*complications/*surgery
MH  - Parathyroidectomy
MH  - Prospective Studies
MH  - Thyroid Cancer, Papillary/*complications
MH  - Thyroid Neoplasms/*complications
MH  - *Thyroidectomy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MEN1
OT  - concomitant thyroid cancer
OT  - concurrent thyroidectomy
OT  - papillary microcarcinoma
OT  - primary hyperparathyroidism
EDAT- 2019/01/05 06:00
MHDA- 2020/02/13 06:00
CRDT- 2019/01/05 06:00
PHST- 2019/01/05 06:00 [pubmed]
PHST- 2020/02/13 06:00 [medline]
PHST- 2019/01/05 06:00 [entrez]
AID - 10.1089/thy.2017.0675 [doi]
PST - ppublish
SO  - Thyroid. 2019 Feb;29(2):252-257. doi: 10.1089/thy.2017.0675.