Μυελοειδές καρκίνωμα θυρεοειδούς σαν τυχαίο εύρημα μετά από λοβεκτομή

CRUCIAL IMPORTANCE OF ACCURATE DIFFERENTIAL DIAGNOSIS BETWEEN SECONDARY AND TERTIARY HYPERPARATHYROIDISM (HPT)

Clinical and laboratory investigation to differentiate between secondary and tertiary HPT (typically occurring in patients with chronic renal failure [the so-called “renal HPT]”) has clinical significance. Most of these patients are asymptomatic and will have abnormalities detected by laboratory and imaging investigation (see table). Imaging of the neck will reveal typically four gland hyperplasia. Patients with both diseases may become clinically symptomatic (bone pain/pathologic fractures, pruritus, nephrolithiasis, pancreatitis, soft tissue or vascular calcifications, mental status changes etc). Accurate differential diagnosis of secondary and tertiary HPT is of crucial importance, since management of patients with secondary HPT is predominantly medical (surgery will be required in only 1-2 % of these patients). In contrast, surgery will eventually be required in patients with tertiary HPT.