Surveillance of Accidental Parathyroid Glands in Post Thyroidectomy Histopathological Specimens

Maram Mohammed Al Ghumlas, Mohammed Gamal Aly, Abdulazi Albidi, Aeshah Abdulmohsen Al Hejji

Abstract: Background: Incidental excision of parathyroid glands is a common event during thyroid surgery, and despite the divergent results that can be obtained from the literature about its clinical significance, all efforts must be used to preserve them. Objective: To study the prevalence of parathyroid tissues in thyroid specimens obtained after thyroidectomy surgeries and its relation post operative hypoparathyroidisim. Materials and methods: From January 2016 to December 2022, 526 consecutive patients with benign and malignant thyroid disorders underwent unilateral or bilateral thyroidectomy at Johns Hopkins Aramco Healthcare (JHAH) center. The histopathological parameters of each patient were blindly determined by one co - author specializing in thyroid and parathyroid pathology. In addition, all pathologic slides were reviewed for the presence, number, and location (extrathyroidal, intrathyroidal, or intracapsular) of inadvertently removed parathyroid glands within the submitted thyroid specimen. Results: 526129 (24.5%) found to have parathyroid tissues were detected among our thyroid specimens, and 58 (44.6%) were in malignant thyroid speciemens parathyroid tissues. In most temporary hypoparathyroidism, 73 (65.8%) hadn't parathyroid tissue in their specimens, 30 had one parathyroid tissue, 7 had two parathyroid tissues, and only one specimen had three tissues. Regarding permanent hypothyroidism, two specimens had no parathyroid tissue, and one specimen had three parathyroid tissues. Conclusion: Incidental parathyroidectomy was common in thyroid surgeries in this study. Although transient hyperparathyroidism had a high percentage, the permanent hypoparthyoidism was extremely low. Further studies are needed to correlate the hypoparathyroidisim with positive parathyroid tissues in thyroid specimens.

Keywords: Specimen, Thyroidectomy, Parathyroid, Tissue, Malignant