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Management of thyroid nodules incidentally discovered on MIBI scanning for primary hyperparathyroidism

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Abstract

Introduction

Parathyroid sestamibi scan is routinely performed before parathyroid surgery. A large number of thyroid cancers take up 99mTc-sestamibi (MIBI). Since 2001, thyroid nodules discovered on sestamibi, nodules >2 cm, and/or with suspicious criteria were resected. The aim of this study was to evaluate the results of this policy.

Methods

All patients operated on for hyperparathyroidism, with a MIBI and cervical ultrasonography (US) with a thyroid resection for nodule, were retrospectively included.

Results

From 2001 to 2013, 685 patients were operated on for hyperparathyroidism. Some 137 (85 % females) had both preoperative MIBI and cervical US and a thyroid resection. The mean age was 63.2 ± 12.8 years. Sixty-three patients had a total thyroidectomy and 74 a lobectomy. Thirty-six patients had a thyroid cancer. The median size of cancers was 6.5 mm (0.3–22 mm), and 23 (16.7 %) patients had microcarcinoma. Among the 137 patients, 44 (32 %) had a MIBI+ nodule including 22 cancers. Sixty-one percent of malignant nodules were MIBI+ (22/36). The median size of MIBI+ cancers was 15 mm (9–22 mm) versus 2 mm (0.3–17 mm) for MIBI− cancers (p = 0.03). Twenty-two percent of benign nodules were MIBI+ (22/101). Finally, the sensitivity, specificity, positive predictive value, and negative predictive value of MIBI were 61, 78, 50, and 85 %, respectively.

Conclusion

Thyroid nodules incidentally discovered on MIBI in hyperparathyroidism patients should be resected.

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Authors and Affiliations

  1. Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l’Appareil Digestif (IMAD), Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Place Alexis Ricordeau, 44093, Nantes, France

    Tristan Greilsamer, Claire Blanchard, Cécile Caillard & Eric Mirallié

  2. Service de Chirurgie Digestive, Générale et Endocrinienne, Hôpital Dupuytren, 87042, Limoges, France

    Niki Christou & Muriel Mathonnet

  3. Service d’Endocrinologie, Centre Hospitalier Universitaire (CHU) Nantes-Hôpital Nord Laennec, Boulevard Jacques-Monod, Saint-Herblain, 44093, Nantes, France

    Delphine Drui, Maelle Le Bras & Bertrand Cariou

  4. Service de Médecine Nucléaire, Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Place Alexis Ricordeau, 44093, Nantes, France

    Catherine Ansquer & Françoise Kraeber-Bodéré

  5. Service de Radiologie, Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Place Alexis Ricordeau, 44093, Nantes, France

    Emmanuelle Mourrain-Langlois & Anne Sophie Delemazure

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  1. Tristan Greilsamer
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  2. Claire Blanchard
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  3. Niki Christou
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Correspondence to Eric Mirallié.

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Greilsamer, T., Blanchard, C., Christou, N. et al. Management of thyroid nodules incidentally discovered on MIBI scanning for primary hyperparathyroidism. Langenbecks Arch Surg 400, 313–318 (2015). https://doi.org/10.1007/s00423-015-1286-y

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  • DOI: https://doi.org/10.1007/s00423-015-1286-y

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