이차성 부갑상선 기능항진증과 동반된 갑상선 결절

Thyroid Nodules in Patients with Secondary Hyperparathyroidism

Purpose: An association between primary hyperparathyroidism and well differentiated thyroid carcinoma has been frequently reported. However, there have been few reports of secondary hyperparathyroidism associated with thyroid carcinoma. This study was performed to evaluate the prevalence of thyroid nodule including thyroid carcinoma in patients with secondary hyperparathyroidism and to suggest more proper diagnostic approach for such cases. Methods: A retrospective study was performed on fifty-two patients who underwent parathyroid surgery for secondary hyperparathyroidism between March, 1986 and December, 2003. Results: In 20 patients (38.5%), thyroid surgery was added because of coexistent thyroid nodules. Five (25%) out of the 22 patients with coexistent thyroid nodule had thyroid carcinoma. Among the 5 thyroid carcinoma patients, 4 had papillary carcinomas and one had a follicular carcinoma. Mean size of thyroid carcinomas was 1.4 cm (0.3∼3.0 cm). Conclusion: The prevalence of thyroid carcinoma in patients with secondary hyperparathyroidism was higher than that in the general population. An aggressive diagnostic approach (ultrasonography and FNAB) should be considered when the patients with secondary hyperparathyroidism present with thyroid nodules. (Korean J Endocrine Surg 2004;4:48-50)