RESUMEN
The coexistance of thyroid diseases with hyperparathyroidism [HPT] can present a challenge in clinical diagnoses and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with HPT, and to analyze the clinical features, diagnosis and treatment of these patients. Thirty patients with hyperparathyroidism were diagnosed and studied in El-Menofia University Hospital in the period from October 2000 to October 2006. Laboratory investigations including serum calcium and parathormone level were established, again localization with neck U/S and technetium-99-Sestamibi. Scan concomitant thyroid disease was also detected. Surgical management was done. Sixteen cases of a total of 30 HPT patients who had synchronous thyroid and parathyroid pathology were managed in this study. Fifteen of them were treated surgically by thyroidectomy and parathyroidectomy and one of them was treated with parathyroidectomy only. During surgery two other thyroid pathology were discovered and two parathyroid found to be intrathyroidal, so we have 19 thyroidectomies; five hemithyroidectomy [26.3%], 13 subtotal thyroidectomy [68.4%] and one total thyroidectomy [5.3%] the pathological diagnosis of concomitant thyroid lesions were nodular goitre in 11 cases [36.7%], follicular adenoma in 2 cases [6.7%] grave's disease in one case [3.3%], one case of thyroiditis [3.3%] and follicular carcinoma in one patient [3.3%]. These result were discussed. we conclude that there is high incidence of concomitant lesions in cases of hyperparathyroidism and we recommend simultaneous ultrasound and TC[99m] Sestamibi scan for better diagnosis and management