Feasibility and safety of minimally invasive radioguided parathyroidectomy using very low intraoperative dose of Tc-99m MIBI

Mehrabibahar, Mostafa; Mousavi, Zohreh; Sadeghi, Ramin; Layegh, Parvin; Nouri, Masoumeh; Asmar, M

doi:10.1016/j.ijsu.2017.02.009

Cited by 23 publications

(8 citation statements)

References 26 publications

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“…CT can detect lesions over 1.5 cm in size. Although reviews are reporting that intraoperative gamma probes can be used for small-sized lesions [7], some surgeons suggest that this method will not be beneficial due to large vessels and heart activities [8]. Intravenous methylene blue is another option to localize ectopic glands.…”

Section: Discussionmentioning

confidence: 99%

Videothoracoscopic resection of a posterior mediastinal parathyroid adenoma in a patient with aberrant subclavian artery

Mestan¹,

Sertbaş²,

Yazgan³

et al. 2020

Curr Thorac Surg

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Approximately 25% of the patients have an ectopic location of the parathyroid gland. In some cases, hyperfunctional parathyroid glands may extend into the mediastinum that requires mediastinal surgical exploration. A 66 years old woman presented with fatigue and raised serum calcium and parathormone levels. Thorax computed tomography revealed a mediastinal mass and an aberrant right subclavian artery (ARSA) which is the most common vascular anomaly of the aortic arch was demonstrated.The mediastinal mass was evaluated in favor of parathyroid adenoma by parathyroid scintigraphy.Videothoracoscopic resection of the adenoma was performed safely.

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Section: Discussionmentioning

confidence: 99%

Videothoracoscopic resection of a posterior mediastinal parathyroid adenoma in a patient with aberrant subclavian artery

Mestan¹,

Sertbaş²,

Yazgan³

et al. 2020

Curr Thorac Surg

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“…A 99mTc sestamibi parathyroid scan and computed tomography of both the neck and the thorax can easily localize the ectopic parathyroid adenoma. Intraoperative radio-guided navigation with a gamma probe can be used for perioperative localization in smaller lesions [ 27 , 28 ]. Alesina et al [ 18 ] considered that the use of a gamma probe could be helpful for reducing the operation time.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic removal of ectopic mediastinal parathyroid adenoma causing hyperparathyroidism: a rare entity.

Erşen¹,

Kılıç²

2018

Videosurgery and Other Miniinvasive Techniques

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Ectopic mediastinal parathyroid adenomas are uncommon. Here, we report the successful thoracoscopic removal of a mediastinal parathyroid adenoma from a patient with hypercalcemia. A 58-year-old female patient was referred to our department with persistent hypercalcemia. Serum calcium and phosphorus levels were 13.2 mg/dl and 2.5 mg/dl respectively, while the intact parathormone level was 798.9 pg/ml. Parathyroid computed tomography revealed a solid and well-defined mass at the anterior mediastinum close to the distal aorta. Once the contrast was enhanced, our pre-diagnosis was ectopic parathyroid adenoma. The mass was detected at the anterior mediastinum, dissected free from the surrounding tissue and excised. The capsulated mass, which had a diameter of 3 × 1.5 × 0.7 cm, was confirmed as parathyroid adenoma histopathologically. Postoperative calcium and parathormone levels decreased dramatically to normal levels. Anterior mediastinal localization of an ectopic parathyroid adenoma is a rare entity. The transsternal approach is the most preferred method, but video-thoracoscopy can be used safely and effectively.

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“…Recently, it has also been reported that radio-guided detection techniques were developed for surgical treatment of parathyroid adenomas. The MIRP (minimally invasive radio-guided parathyroidectomy) technique allows a low dose (1 mCi) of Tc-99m MIBI without intraoperative PTH assay and frozen section analysis leading to excellent cure rate for PHPT (15).…”

Section: Discussionmentioning

confidence: 99%

Comparison of video-assisted thoracic surgery with open surgery in the treatment of ectopic mediastinal parathyroid tumors

Shi

Zhu

et al. 2017

J. Thorac. Dis.

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Background: To investigate the therapeutic effect of different surgical treatment for ectopic mediastinal parathyroid tumors and pathological features.Methods: A total of 21 patients who were diagnosed with ectopic mediastinal parathyroid tumors and underwent surgeries in our department from May 1995 to May 2015 were collected and retrospectively analyzed.Results: Twenty-one patients including 8 female (36.4%) and 13 male (63.6%) were collected. Among these patients, 9 cases were treated with video-assisted thoracic surgery (VATS), while 13 cases were treated with open surgery (including one secondary open operation after thoracoscopic operation). The average size of mediastinal tumors was 2.17±1.22 cm. For the post-operational pathology, 16 cases (76.2%) were diagnosed as ectopic parathyroid adenoma; 4 cases (19.0%) were diagnosed as parathyroid hyperplasia, while only 1 case (4.8%) was diagnosed as parathyroid adenocarcinoma.Conclusions: Parathyroid adenoma accounts for the major pathological type of ectopic mediastinal parathyroid tumors. In addition, the correct diagnosis with precise preoperative location was the key for the treatment of ectopic mediastinal parathyroid tumors accompanied with hyperparathyroidism. Surgical intervention was demonstrated to be an effective way for the treatment of ectopic mediastinal parathyroid tumors with satisfied therapeutic outcome, especially for the VATS due to its unique clinical advantages.However, there may some difficulties when locating ectopic mediastinal parathyroid tumor less than 1 cm and the operators should be very cautious when performing thoracoscopic operations. Ruijin Hospital within recent 20 years were collected and retrospectively analyzed, including both surgical procedures and pathological studies. MethodsThis study included 21 cases of patients (13 males and 8 females) who were diagnosed with ectopic mediastinal parathyroid tumors and treated with surgical resection from May 1995 to May 2015 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Written informed consent was obtained from all the patients for clinical data collection and accompanying images, as well as potential publication. All the patients underwent the examination of blood calcium, blood phosphorus and PTH before and after surgery. The location of the tumors was examined by computed tomography (CT), magnetic resonance imaging (MRI), or Technetium-99m sestamibi scanning ( 99m Tc-MIBI). Technetium-99m sestamibi scanning is considered the gold standard for clinical location. Ectopic mediastinal parathyroid tumors were finally confirmed by post-operational pathology. After surgery, all the patients followed up at least every three months till one year postoperation. Statistical analysisThe software SPSS13.0 was utilized for statistical analysis. The measurement data was analyzed by t-test and the count data was analyzed by χ 2 test. Results Clinical informationTwenty-one patients were firstly found hypercalcemia by physical examination without any specific symptoms, and...

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Feasibility and safety of minimally invasive radioguided parathyroidectomy using very low intraoperative dose of Tc-99m MIBI

Cited by 23 publications

References 26 publications

Videothoracoscopic resection of a posterior mediastinal parathyroid adenoma in a patient with aberrant subclavian artery

Videothoracoscopic resection of a posterior mediastinal parathyroid adenoma in a patient with aberrant subclavian artery

Thoracoscopic removal of ectopic mediastinal parathyroid adenoma causing hyperparathyroidism: a rare entity.

Comparison of video-assisted thoracic surgery with open surgery in the treatment of ectopic mediastinal parathyroid tumors

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