Benign Parathyroid Gland Tumors and their Heterogeneity

Kowalski, Grzegorz; a, Grzegorz Bu; Polczyk, Joanna; Gawrychowska, Agata; Bednarczyk, Adam; Werbowski, Marcin; Lackowska, Bo ena; Gawrychowski, Jacek

doi:10.26502/jsr.10020102

Cited by 1 publication

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“…The therapy is based on a surgical approach. In MGD, complete removal of all enlarged parathyroid glands is necessary [ 15 , 19 ]. Appropriate surgical therapy of MGD should consist of a bilateral approach in most patients.…”

Section: Discussionmentioning

confidence: 99%

“…These PET tracers open new avenues for radionuclide imaging of parathyroid glands. Equally important is the genetic study that is now easily carried out with the NGS technique on several genes [ 5 , 19 ]. To distinguish adenoma from carcinoma, biopsy in parathyroid carcinoma can lead to tumor dissemination.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment in MGD requires more surgical experience and judgment compared to the excision of a solitary adenoma [ 5 , 9 ]. Recurrent/persistence pHPT occurs more frequently in patients with double adenomas; hence, in situations where a double adenoma has been identified, the surgeon should have a high index of suspicion during surgery and postoperatively for the possibility of a four-gland disease [ 1 , 5 , 19 ]. All tissues that were removed should be sent for pathology for further evaluation and the exclusion of the presence of cancerous cells.…”

Section: Discussionmentioning

confidence: 99%

“…MRI are useful in the detection of particularly ectopic extra parathyroid mediastinal lesions [ 5 , 17 ]. The treatment of MGD is surgery-parathyroidectomy (PTX) with the use of an intraoperative PTH (iPTH) level [ 18 , 19 , 20 ]. The aim of our study was to review the clinical characteristics and management of MGD and the evaluation of surgical treatment failures.…”

Section: Introductionmentioning

confidence: 99%

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Multiglandular Parathyroid Disease

Kowalski¹,

Buła²,

Bednarczyk³

et al. 2022

Life

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Introduction: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8–33% of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical treatment failures. Methods: We performed a retrospective study of 163 patients with pHPT undergoing parathyroidectomy (PTX) at the Department of General and Endocrine Surgery between 1983 and 2018. All these patients were diagnosed with MGD. This group of patients was compared with a group of 856 patients with solitary disease operated for pHPT in the same period. Results: Among 163 patients—127 (79%) of them had two lesions, 28 (16%) had three, and 8 (5%) four. They were prevalently women over the age of 50. The diagnosis was based on PTH and ionized calcium studies and used sestamibi technetium-99m scintigraphy (MIBI) as well for us. Treatment was surgical. Conclusions: Parathyroidectomy (PTX) for multiglandular parathyroid disease (MGD) is associated with a higher operative risk of failure compared to solitary disease. Preoperative diagnosis and localization of the parathyroid glands is an extremely important element of treatment. Diagnosis is based on PTH and calcium levels. Ultrasonography (USG), MRI, and scintigraphy are very helpful in diagnosis. Mediastinal multiglandular parathyroid disease (MGD) is associated with increased surgical treatment failures. The treatment is surgical and consists of the removal of the masses or complete parathyroidectomy. Based on this study, we support the existence of multiple adenomas and advocate the removal of only macroscopically enlarged parathyroid glands in patients with primary hyperparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%