Surgery for Primary Hyperparathyroidism 1962-1996: Indications and Outcomes

Delbridge, Leigh; Younes, Nidal A.; Guinea, Ana I.; Reeve, T. S.; Clifton‐Bligh, P.; Robinson, Bruce G.

doi:10.1016/s0022-5347(01)62032-9

Cited by 30 publications

(42 citation statements)

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“…Parathyroidectomy (PTx) should be considered in most symptomatic patients with confirmed pHPT, and bilateral neck exploration represents the standard initial surgical procedure since, in recent series, the overall reported cure rates may reach 95± 98% (3,4). Localization studies were often performed to simplify and shorten surgical exploration, but nevertheless a significant reduction in morbidity and duration of surgery was not reported in all studies and, for some surgeons, preoperative imaging of the parathyroid (PT) glands was unnecessary (5±8).…”

Section: Introductionmentioning

confidence: 99%

Advantages of combined technetium-99m-sestamibi scintigraphy and high-resolution ultrasonography in parathyroid localization: comparative study in 91 patients with primary hyperparathyroidism

Lumachi

Zucchetta

Marzola

et al. 2000

European Journal of Endocrinology

145

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Objective: To evaluate the usefulness of the combination of 99m Tc-sestamibi/ 99m Tc-pertechnetate subtraction scintigraphy (SS) and high-resolution neck ultrasonography (US) in patients with primary hyperparathyroidism (pHPT) undergoing parathyroidectomy. Design and Methods: Ninety-one patients with proved pHPT were studied, excluding patients with persistent or recurrent disease. There were 65 (71.4%) women and 26 (28.6%) men, with a median age of 59 years (range 18±78 years). All patients underwent both SS and US prior to surgery, and the results were compared with operative and histological findings. The intraoperative quick-parathyroid hormone assay was available for 52 (57.1%) patients. When multiglandular disease was found, both SS and US were considered truly positive only when at least two enlarged parathyroid (PT) glands had been localized. Results: Eighty-three (91.2%) solitary PT adenomas and three (3.3%) carcinomas were found. Moreover, two (2.2%) patients had a double adenoma and three (3.3%) patients had diffuse PT hyperplasia. The overall sensitivity of combined SS US was 94.5% (86.8% and 80.4% for SS and US respectively). There was a significant P , 0X05Y Student's t-test) difference in size between the PT glands correctly identified and undetected by SS, whereas the site of the removed PT tumors significantly P , 0X05Y Fisher exact test) influenced only the US sensitivity. Conclusions: When the preoperative localization of the PT glands is chosen, the combination of SS and US represents a reliable noninvasive localization technique and should be considered for use in each patient with pHPT undergoing surgery.

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Section: Introductionmentioning

confidence: 99%

Advantages of combined technetium-99m-sestamibi scintigraphy and high-resolution ultrasonography in parathyroid localization: comparative study in 91 patients with primary hyperparathyroidism

Lumachi

Zucchetta

Marzola

et al. 2000

European Journal of Endocrinology

145

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“…[8] In hyperparathyroid bone disease and hypercalcemia surgical exploration of the neck is recommended. [3] After parathyroidectomy, the serum PTH level falls dramatically, bone resorption stops resulting in marked increase in bone uptake of calcium and phosphate( the so called hungry bone syndrome). We conclude that in a patient presenting with pathological fracture, primary hyperparathyroidism should be kept as differential diagnosis with screening of the whole skeleton.…”

Section: Discussionmentioning

confidence: 99%

“…[2] In the majority of patients with primary hyperparathyroidism (85%) caused by solitary parathyroid adenoma (single gland disease), whereas 13% have hyperplasia (multiple gland disease), 1-2% have double adenoma and 1% have carcinoma. [3] Due to parathormone hypersecretion, several consequences occur such as excess calcium reabsorption from kidneys, phosphaturia, increased vitamin D synthesis and bone reabsorption. Parathormone increases osteoclastic activity.…”

Section: Introductionmentioning

confidence: 99%

Brown Tumor: Rare Skeletal Presentation Secondary to Hyperparathyroidism

Patwa¹,

Patel²,

Patel³

et al. 2015

Int J of Biomed & Adv Res

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Brown tumor is a giant cell lesion associated with hypepararthyroidism. It is a non-neoplastc condition and represents terminal stage of the remodeling process in hyperparathyroid state. This severe parathyroid bone disease is a rare clinical presentation of primary hyperparathyroidism which is due most often to a parathyroid adenoma, secreting parathormone(PTH). Elevated PTH levels cause bone resorption, the formation of polyostotic lesions and a reduction in bone mineral density, predisposing to pathological fractures. Here we report the case of young female having primary hyperthyroidism due to parathyroid adenoma with osteolytic cysic lesions at distal femur, distal end clavicle, iliac bone. She was treated with surgical excision of parathyroid with curettage, autogenous bone grafting, internal fixation with plate after confirming the biopsy report and biochemical, histopathological investigations. At the follow up time patient had no symptoms with full range of motions at knee with excellent fracture healing.

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“…Longer term follow-up of series containing different proportions of patients with mild HPT have demonstrated reversed hypercalcemia from in 90-95% of the cases (Bruining et al 198 1, Lundgren et al 1992) up to virtually all of the examined individuals (Ronni-Sivula & Sivula 1985, van Heerden & Grant 1991, Uden et al 1992, Delbridge et al 1998. Analyses of materials of mild HPT (Attie et al 1976, Russel & Edis 1982, Gaz & Wang 1984 and elderly cases (Brothers & Thompson 1987, Ohrvall et al 1994, Ruijs et al 1994, Chigot et al 1995 infer similar expectations regarding the serum calcium level.…”

Section: Serum Calcium and Pthmentioning

confidence: 99%

“…Persistence and recurrence of HPT The success rate of primary parathyroid explorations at larger centres has indicated that persistent postoperative hypercalcemia is truly rare (van Heerden & Grant 1991, Lundgren et al 1992, Weber et al 1994, Rafferty et al 1997, Ryan & Lee 1997, Delbridge et al 1998. Recurrence rates in patients followed for longer periods of time after extirpation of a single parathyroid gland seem to be below 2-3% (Ronni-Sivula & Sivula 1985, Rudberg et al 1986, Lundgren et al 1992.…”

Section: Serum Calcium and Pthmentioning

confidence: 99%

Primary Hyperparathyroidism of Postmenopausal Women

Lundgren¹

1999

Upsala Journal of Medical Sciences

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Surgery for Primary Hyperparathyroidism 1962-1996: Indications and Outcomes

Cited by 30 publications

References 0 publications

Advantages of combined technetium-99m-sestamibi scintigraphy and high-resolution ultrasonography in parathyroid localization: comparative study in 91 patients with primary hyperparathyroidism

Advantages of combined technetium-99m-sestamibi scintigraphy and high-resolution ultrasonography in parathyroid localization: comparative study in 91 patients with primary hyperparathyroidism

Brown Tumor: Rare Skeletal Presentation Secondary to Hyperparathyroidism

Primary Hyperparathyroidism of Postmenopausal Women

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