World wide what? The quality of information on parathyroid disease available on the Internet.

BACKGROUND: Patients are relying on the Internet with greater frequency to learn about diseases and make medical decisions. We hypothesized that there is a disparity between the perceptions of patients and those of surgeons regarding the quality of information about primary hyperparathyroidism on the Internet. METHODS: Patients (n = 62) with primary hyperparathyroidism seen in endocrine surgery clinics in France and the United States responded to a survey regarding their use of the Internet to prepare for upcoming parathyroid surgery. A panel of endocrine surgeons reviewed the top "hits" retrieved from Web sites related to parathyroid disease. Sites were rated using a previously validated Web site quality scoring system. RESULTS: A total of 75% of the American cohort and 53% of the French cohort used the Internet to prepare for parathyroid surgery. The majority of these patients reported that the information was "somewhat to very accurate." The panel of surgeons gave the Web sites an overall average qualitative score of 8.6 (53%). CONCLUSION: Surgeons and patients have different perceptions as to what constitutes a high-quality Web site. As patients depend more on the Internet to prepare for parathyroid surgery, there is an opportunity and a clear need to create comprehensive, high-quality, patient-oriented Web sites on this topic.

Metastatic struma ovarii treated with total thyroidectomy and radioiodine ablation.

OBJECTIVE: To present a rare case of metastatic struma ovarii, review the related literature, and discuss the management. METHODS: A case report of a patient with metastatic struma ovarii is presented. The treatment plan, postoperative care, and follow-up are discussed. We conducted a MEDLINE search of the English-language literature seeking additional cases of metastatic struma ovarii. In addition to the current case, the previous 40 cases of metastatic struma ovarii were reviewed and analyzed. RESULTS: The mean age of the patients at presentation was 43 years. All patients underwent resection of the primary tumor. The most common sites of involvement for struma ovarii metastatic disease have been the peritoneum, mesentery, and omentum. After primary tumor resection, a wide range of additional treatments have been used, including chemotherapy, resection of metastatic disease, external beam radiation therapy, and radioiodine ablation. CONCLUSION: In cases of metastatic struma ovarii, we recommend total thyroidectomy in conjunction with radioiodine scanning and radioiodine ablation. Thyroglobulin levels should be followed as a tumor marker, and diagnostic radioiodine scans should be performed to screen for residual or recurrent disease. Although this treatment strategy is well established for thyroid cancer, long-term outcomes of this treatment for struma ovarii are still unknown.