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Erschienen in: Langenbeck's Archives of Surgery 8/2014

01.12.2014 | Original Article

Surgical strategy for primary hyperparathyreoidism with thyroid hemiagenesis

verfasst von: Cesare Carlo Ferrari, Kerstin Lorenz, Gianlorenzo Dionigi, Henning Dralle

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 8/2014

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Abstract

Background

Thyroid hemiagenesis is a rare congenital anomaly, and still more rarely associated with primary hyperparathyroidism (pHPT). Due to the embryologic pathways of the thyroid and parathyroid glands, it remains unclear whether or not thyroid hemiagenesis may be linked to ipsilateral parathyroid agenesis, and consequently, surgical strategy for thyroid hemiagenesis associated pHPT (THAP) does not only depend on preoperative localization but also on the thyroid anomaly.

Methods

Including the present case report, a total of nine cases with THAP retrieved from the literature were reviewed. Seven of nine cases had thyroid hemiagenesis on the left side, three out of nine showed a parathyroid adenoma on the contralateral side to the thyroid hemiagenesis.

Conclusions

Based on these cases, it can be concluded that the embryologic pathways of the thyroid and parathyroid glands are different, and in cases of THAP, parathyroid exploration should follow standard recommendations for pHPT surgery.
Literatur
1.
Zurück zum Zitat Agarwal A, Mishra A, Lombardi CP, Raffaelli M (2013) Chapter 2—Applied embryology of the thyroid and parathyroid glands. In: Randolph GW (ed) Surgery of the thyroid and parathyroid glands, Secondth edn. Saunders/Elsevier, Philadelphia, pp 15–24 Agarwal A, Mishra A, Lombardi CP, Raffaelli M (2013) Chapter 2—Applied embryology of the thyroid and parathyroid glands. In: Randolph GW (ed) Surgery of the thyroid and parathyroid glands, Secondth edn. Saunders/Elsevier, Philadelphia, pp 15–24
2.
Zurück zum Zitat Nishiyama I, Ogiso M, Oota T, Kimura T, Seki T (1996) Developmental Change in expression of highly polysialylated neural cell adhesion molecule in C-cells in rat thyroid gland. Anat Embryol (Berl) 194:419–426CrossRef Nishiyama I, Ogiso M, Oota T, Kimura T, Seki T (1996) Developmental Change in expression of highly polysialylated neural cell adhesion molecule in C-cells in rat thyroid gland. Anat Embryol (Berl) 194:419–426CrossRef
3.
Zurück zum Zitat Macchia PE (2000) Recent Advances in understanding the molecular basis of primary congenital hypothyroidism. Mol Med Today 6:36–42PubMedCrossRef Macchia PE (2000) Recent Advances in understanding the molecular basis of primary congenital hypothyroidism. Mol Med Today 6:36–42PubMedCrossRef
4.
Zurück zum Zitat De Felice M, Ovitt C, Biffali E, Rodriguez-Mallon A, Arra C, Anastassiadis K, Macchia PE, Mattei MG, Mariano A, Scholer H, Macchia V, Di Lauro R (1998) A Mouse model for hereditary thyroid dysgenesis and cleft palate. Nat Genet 19:395–398PubMedCrossRef De Felice M, Ovitt C, Biffali E, Rodriguez-Mallon A, Arra C, Anastassiadis K, Macchia PE, Mattei MG, Mariano A, Scholer H, Macchia V, Di Lauro R (1998) A Mouse model for hereditary thyroid dysgenesis and cleft palate. Nat Genet 19:395–398PubMedCrossRef
5.
Zurück zum Zitat Gursoy A, Anil C, Unal AD, Demirer AN, Tutuncu NB, Erdogan MF (2008) Clinical and Epidemiological characteristics of thyroid hemiagenesis: ultrasound screening in patients with thyroid disease and normal population. Endocrine 33:338–341PubMedCrossRef Gursoy A, Anil C, Unal AD, Demirer AN, Tutuncu NB, Erdogan MF (2008) Clinical and Epidemiological characteristics of thyroid hemiagenesis: ultrasound screening in patients with thyroid disease and normal population. Endocrine 33:338–341PubMedCrossRef
6.
Zurück zum Zitat Melnick JC, Stemkowski PE (1981) Thyroid Hemiagenesis (hockey stick sign): a review of the world literature and a report of four cases. J Clin Endocrinol Metab 52:247–251PubMedCrossRef Melnick JC, Stemkowski PE (1981) Thyroid Hemiagenesis (hockey stick sign): a review of the world literature and a report of four cases. J Clin Endocrinol Metab 52:247–251PubMedCrossRef
7.
Zurück zum Zitat Mikosch P, Gallowitsch HJ, Kresnik E, Molnar M, Gomez I, Lind P (1999) Thyroid hemiagenesis in an endemic goiter area diagnosed by ultrasonography: report of sixteen patients. Thyroid 9:1075–1084PubMedCrossRef Mikosch P, Gallowitsch HJ, Kresnik E, Molnar M, Gomez I, Lind P (1999) Thyroid hemiagenesis in an endemic goiter area diagnosed by ultrasonography: report of sixteen patients. Thyroid 9:1075–1084PubMedCrossRef
8.
Zurück zum Zitat Ruchala M, Szczepanek E, Szaflarski W, Moczko J, Czarnywojtek A, Pietz L, Nowicki M, Niedziela M, Zabel M, Kohrle J, Sowinski J (2010) Increased risk of thyroid pathology in patients with thyroid hemiagenesis: results of a large cohort case-control study. Eur J Endocrinol 162:153–160PubMedCrossRef Ruchala M, Szczepanek E, Szaflarski W, Moczko J, Czarnywojtek A, Pietz L, Nowicki M, Niedziela M, Zabel M, Kohrle J, Sowinski J (2010) Increased risk of thyroid pathology in patients with thyroid hemiagenesis: results of a large cohort case-control study. Eur J Endocrinol 162:153–160PubMedCrossRef
9.
Zurück zum Zitat Duh QY, Ciulla TA, Clark OH (1994) Primary parathyroid hyperplasia associated with thyroid hemiagenesis and agenesis of the isthmus. Surgery 115:257–263PubMed Duh QY, Ciulla TA, Clark OH (1994) Primary parathyroid hyperplasia associated with thyroid hemiagenesis and agenesis of the isthmus. Surgery 115:257–263PubMed
10.
Zurück zum Zitat Isreb S, Alem F, Smith D (2010) Left thyroid hemiagenesis in a patient with primary hyperparathyroidism. BMJ Case Rep 2010 Isreb S, Alem F, Smith D (2010) Left thyroid hemiagenesis in a patient with primary hyperparathyroidism. BMJ Case Rep 2010
11.
Zurück zum Zitat Kroeker TR, Stancoven KM, Preskitt JT (2011) Parathyroid Adenoma on the ipsilateral side of thyroid hemiagenesis. Proc (Bayl Univ Med Cent) 24:92–93 Kroeker TR, Stancoven KM, Preskitt JT (2011) Parathyroid Adenoma on the ipsilateral side of thyroid hemiagenesis. Proc (Bayl Univ Med Cent) 24:92–93
12.
Zurück zum Zitat Maganini RJ, Narendran K (1977) Hyperparathyroidism in a Patient with thyroid hemiagenesis. IMJ Ill Med J 151:368–370PubMed Maganini RJ, Narendran K (1977) Hyperparathyroidism in a Patient with thyroid hemiagenesis. IMJ Ill Med J 151:368–370PubMed
13.
Zurück zum Zitat Mydlarz WK, Zhang K, Micchelli ST, Kim M, Tufano RP (2010) Ipsilateral double parathyroid adenoma and thyroid hemiagenesis. ORL J Otorhinolaryngol Relat Spec 72:272–274PubMedCrossRef Mydlarz WK, Zhang K, Micchelli ST, Kim M, Tufano RP (2010) Ipsilateral double parathyroid adenoma and thyroid hemiagenesis. ORL J Otorhinolaryngol Relat Spec 72:272–274PubMedCrossRef
14.
Zurück zum Zitat Oruci M, Ito Y, Buta M, Radisavljevic Z, Pupic G, Djurisic I, Dzodic R (2012) Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands—case report. BMC Endocr Disord 12:29PubMedCentralPubMedCrossRef Oruci M, Ito Y, Buta M, Radisavljevic Z, Pupic G, Djurisic I, Dzodic R (2012) Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands—case report. BMC Endocr Disord 12:29PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Sakurai K, Amano S, Enomoto K, Matsuo S, Kitajima A (2007) Primary hyperparathyroidism with thyroid hemiagenesis. Asian J Surg 30:151–153PubMedCrossRef Sakurai K, Amano S, Enomoto K, Matsuo S, Kitajima A (2007) Primary hyperparathyroidism with thyroid hemiagenesis. Asian J Surg 30:151–153PubMedCrossRef
16.
Zurück zum Zitat Woods RH, Loury M (1992) Thyroid Hemiagenesis in a patient with a parathyroid adenoma. Otolaryngol Head Neck Surg 107:469–471PubMed Woods RH, Loury M (1992) Thyroid Hemiagenesis in a patient with a parathyroid adenoma. Otolaryngol Head Neck Surg 107:469–471PubMed
17.
Zurück zum Zitat Mohebati A, Shaha AR (2012) Anatomy of thyroid and parathyroid glands and neurovascular relations. Clin Anat 25:19–31PubMedCrossRef Mohebati A, Shaha AR (2012) Anatomy of thyroid and parathyroid glands and neurovascular relations. Clin Anat 25:19–31PubMedCrossRef
18.
Zurück zum Zitat Policeni BA, Smoker WR, Reede DL (2012) Anatomy and embryology of the thyroid and parathyroid glands. Semin Ultrasound CT MR 33:104–114PubMedCrossRef Policeni BA, Smoker WR, Reede DL (2012) Anatomy and embryology of the thyroid and parathyroid glands. Semin Ultrasound CT MR 33:104–114PubMedCrossRef
19.
Zurück zum Zitat Sadler Thomas W (2012) Langman’s medical embryology, 12th edn. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, xiii, 384 p.: col. ill.; 26 cm Sadler Thomas W (2012) Langman’s medical embryology, 12th edn. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, xiii, 384 p.: col. ill.; 26 cm
20.
Zurück zum Zitat Kameda Y, Nishimaki T, Chisaka O, Iseki S, Sucov HM (2007) Expression of the epithelial marker E-Cadherin by thyroid C Cells and their precursors during murine development. J Histochem Cytochem 55:1075–1088PubMedCrossRef Kameda Y, Nishimaki T, Chisaka O, Iseki S, Sucov HM (2007) Expression of the epithelial marker E-Cadherin by thyroid C Cells and their precursors during murine development. J Histochem Cytochem 55:1075–1088PubMedCrossRef
21.
Zurück zum Zitat Grevellec A, Tucker AS (2010) The Pharyngeal pouches and clefts: development, evolution, structure and derivatives. Semin Cell Dev Biol 21:325–332PubMedCrossRef Grevellec A, Tucker AS (2010) The Pharyngeal pouches and clefts: development, evolution, structure and derivatives. Semin Cell Dev Biol 21:325–332PubMedCrossRef
22.
Zurück zum Zitat Todd R (1852) The Cyclopaedia of anatomy and physiology. Sherwood, London, p 1103, IV part II Todd R (1852) The Cyclopaedia of anatomy and physiology. Sherwood, London, p 1103, IV part II
24.
Zurück zum Zitat Korpal-Szczyrska M, Kosiak W, Swieton D (2008) Prevalence of thyroid hemiagenesis in an asymptomatic schoolchildren population. Thyroid 18:637–639PubMedCrossRef Korpal-Szczyrska M, Kosiak W, Swieton D (2008) Prevalence of thyroid hemiagenesis in an asymptomatic schoolchildren population. Thyroid 18:637–639PubMedCrossRef
25.
Zurück zum Zitat Maiorana R, Carta A, Floriddia G, Leonardi D, Buscema M, Sava L, Calaciura F, Vigneri R (2003) Thyroid Hemiagenesis: prevalence in normal children and effect on thyroid function. J Clin Endocrinol Metab 88:1534–1536PubMedCrossRef Maiorana R, Carta A, Floriddia G, Leonardi D, Buscema M, Sava L, Calaciura F, Vigneri R (2003) Thyroid Hemiagenesis: prevalence in normal children and effect on thyroid function. J Clin Endocrinol Metab 88:1534–1536PubMedCrossRef
26.
Zurück zum Zitat Shabana W, Delange F, Freson M, Osteaux M, De Schepper J (2000) Prevalence of Thyroid hemiagenesis: ultrasound screening in normal children. Eur J Pediatr 159:456–458PubMedCrossRef Shabana W, Delange F, Freson M, Osteaux M, De Schepper J (2000) Prevalence of Thyroid hemiagenesis: ultrasound screening in normal children. Eur J Pediatr 159:456–458PubMedCrossRef
27.
Zurück zum Zitat Hamburger JI, Hamburger SW (1970) Thyroidal Hemiagenesis. report of a case and comments on clinical ramifications. Arch Surg 100:319–320PubMedCrossRef Hamburger JI, Hamburger SW (1970) Thyroidal Hemiagenesis. report of a case and comments on clinical ramifications. Arch Surg 100:319–320PubMedCrossRef
28.
Zurück zum Zitat Mclean R, Howard N, Murray IP (1985) Thyroid Dysgenesis in monozygotic twins: variants identified by scintigraphy. Eur J Nucl Med 10:346–348PubMedCrossRef Mclean R, Howard N, Murray IP (1985) Thyroid Dysgenesis in monozygotic twins: variants identified by scintigraphy. Eur J Nucl Med 10:346–348PubMedCrossRef
29.
Zurück zum Zitat Rajmil HO, Rodriguez-Espinosa J, Soldevila J, Ordonez-Llanos J (1984) Thyroid hemiagenesis in two sisters. J Endocrinol Invest 7:393–394PubMedCrossRef Rajmil HO, Rodriguez-Espinosa J, Soldevila J, Ordonez-Llanos J (1984) Thyroid hemiagenesis in two sisters. J Endocrinol Invest 7:393–394PubMedCrossRef
30.
Zurück zum Zitat Kirmizibekmez H, Guven A, Yildiz M, Cebeci AN, Dursun F (2012) Developmental defects of the thyroid gland: relationship with advanced maternal age. J Clin Res Pediatr Endocrinol 4:72–75PubMedCentralPubMedCrossRef Kirmizibekmez H, Guven A, Yildiz M, Cebeci AN, Dursun F (2012) Developmental defects of the thyroid gland: relationship with advanced maternal age. J Clin Res Pediatr Endocrinol 4:72–75PubMedCentralPubMedCrossRef
31.
Zurück zum Zitat Trueba SS, Auge J, Mattei G, Etchevers H, Martinovic J, Czernichow P, Vekemans M, Polak M, Attie-Bitach T (2005) Pax8, Titf1, and Foxe1 Gene expression patterns during human development: new insights into human thyroid development and thyroid dysgenesis-associated malformations. J Clin Endocrinol Metab 90:455–462PubMedCrossRef Trueba SS, Auge J, Mattei G, Etchevers H, Martinovic J, Czernichow P, Vekemans M, Polak M, Attie-Bitach T (2005) Pax8, Titf1, and Foxe1 Gene expression patterns during human development: new insights into human thyroid development and thyroid dysgenesis-associated malformations. J Clin Endocrinol Metab 90:455–462PubMedCrossRef
32.
Zurück zum Zitat Castanet M, Leenhardt L, Leger J, Simon-Carre A, Lyonnet S, Pelet A, Czernichow P, Polak M (2005) Thyroid hemiagenesis is a rare variant of thyroid dysgenesis with a familial component but without Pax8 Mutations in a cohort of 22 cases. Pediatr Res 57:908–913PubMedCrossRef Castanet M, Leenhardt L, Leger J, Simon-Carre A, Lyonnet S, Pelet A, Czernichow P, Polak M (2005) Thyroid hemiagenesis is a rare variant of thyroid dysgenesis with a familial component but without Pax8 Mutations in a cohort of 22 cases. Pediatr Res 57:908–913PubMedCrossRef
33.
Zurück zum Zitat De Remigis P, D’angelo M, Bonaduce S, Di Giandomenico V, Sensi S (1985) Comparison of ultrasonic scanning and scintiscanning in the evaluation of thyroid hemiagenesis. J Clin Ultrasound 13:561–563PubMedCrossRef De Remigis P, D’angelo M, Bonaduce S, Di Giandomenico V, Sensi S (1985) Comparison of ultrasonic scanning and scintiscanning in the evaluation of thyroid hemiagenesis. J Clin Ultrasound 13:561–563PubMedCrossRef
34.
Zurück zum Zitat Wu YH, Wein RO, Carter B (2012) Thyroid hemiagenesis: a case series and review of the literature. Am J Otolaryngol 33:299–302PubMedCrossRef Wu YH, Wein RO, Carter B (2012) Thyroid hemiagenesis: a case series and review of the literature. Am J Otolaryngol 33:299–302PubMedCrossRef
Metadaten
Titel
Surgical strategy for primary hyperparathyreoidism with thyroid hemiagenesis
verfasst von
Cesare Carlo Ferrari
Kerstin Lorenz
Gianlorenzo Dionigi
Henning Dralle
Publikationsdatum
01.12.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 8/2014
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-014-1228-0

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