Card 1 of 28: Pathology distribution
END-PTH-DIS-01
Pathology distribution
Cause of sporadic pHPT at surgery/pathology
The number is concealed — recall it first, then flip the card and grade yourself honestly.
END-PTH-DIS-01 · Pathology distribution
ADOPTED (guideline): single adenoma ~85% · multigland disease ~15% (of which double adenomas ~4–5%, hyperplasia ~10%) · carcinoma <1%
full dispute in D2
🔴 Disputed. Sources disagree — the dispute table is on the card
Applies to — the population, exactly as printed
Surgical series & guideline populations
Basis — n / evidence base
AAES guideline (MGD ≈15%, overall reported range 6–33%); Ruda SR: 20,225 cases
Evidence tier (the registry's wording)
Guideline vs SR — 🔴 resolved
Dispute — the sources disagree
Source · Single adenoma · Multigland disease · Double adenoma · Hyperplasia · Carcinoma · Basis
Ruda et al. SR, 2005 · 88.9% · ~10% · 4.1% · 5.7% · 0.74% · 20,225 cases pooled from published surgical series, 1995–2003, pathology-report classification
AAES Guideline, 2016 (ADOPTED) · ~85% · ~15% (reported range across series 6–33%) · (within MGD) · (within MGD) · <1% · Guideline synthesis incl. bilateral-exploration series with complete gland ascertainment
Why they differ
Difference in ascertainment: the published Ruda series mostly came from concentrated surgical centres classifying by pathology reports in an era when some multigland disease was recorded as a single adenoma; while the AAES guideline includes bilateral-exploration series in which all four glands are examined, so multiplicity appears in full.
Adopted
The AAES set (single ~85% · multiple ~15% · cancer <1%).
Grade yourself — spaced repetition
Verification stamp: 🔴 Disputed · Registry audit 2026-11-06 · Pending triple review · Surgery Code registry — family file 11 (11-thyroid-parathyroid-expanded.md), coded unit; registry audit 2026-11-06. Permalink to this card