With a reported incidence of 1.6% to 50%,^1,2 postoperative hypocalcemia is the most common and sometimes the most severe complication observed after total thyroidectomy. Therefore patients must undergo close postoperative observation and frequent laboratory evaluations. The reasons for postoperative hypoparathyroidism are devascularization of parathyroid glands during surgery owing to the close proximity of the thyroid capsule, the accidental removal of 1 or more parathyroid gland(s), destruction of the parathyroid glands as a result of lymphadenectomy along the recurrent laryngeal nerve (RLN), or hypoparathyroidism due to hematoma formation.^3,4

DIAGNOSIS OF pheochromocytoma still poses considerable problems, as almost half of patients initially have no or only paroxysmal hypertension or may even be asymptomatic.¹ Even the classic symptom triad of bilateral diffuse headache, sweating, and palpitations provides diagnostic accuracy of only 6%.² Autopsy studies show that the disease is not recognized in 20% to 75% of patients during life but represents the cause of death in half of them.^3,4 Proper diagnosis of pheochromocytoma by highly sensitive biochemical tests therefore remains of paramount importance.

Papillary (PTC) and follicular thyroid carcinoma (FTC) are known as differentiated thyroid carcinoma (DTC). Nevertheless, according to the UICC/AJCC (TNM) classification PTC and FTC are frequently analyzed as one cancer. The aim of this study is to show differences in outcome and specific prognostic factors in an iodine-replete endemic goiter region. Six hundred and three patients with DTC treated within a 35-year-period were retrospectively analyzed with respect to carcinoma-specific survival. Prognostic factors were tested for their significance using univariate and multivariate analysis. The histological type (PTC versus FTC) was found to be a highly significant factor - carcinoma-specific survival both in univariate (P or =45 years, positive lymph nodes and increasing tumor size were confirmed as independent prognostic factors. Univariate analysis of FTC patients revealed age at presentation, gender, extrathyroidal tumor spread, lymph node and distant metastases, increasing tumor size, multifocality, widely invasive tumor growth and oxyphilic variant to be factors bearing prognostic significance. The presence of distant metastases and increasing tumor size could be identified as independent prognostic factors for FTC patients. This study shows distinctive differences in prognostic factors of PTC and FTC: independent factors predicting poor prognosis are age > or =45 years, positive lymph nodes and increasing tumor size for PTC, and distant metastases and increasing tumor size for FTC. PTC and FTC patients should be analyzed and reported separately.