Location of Parathyroid Adenomas: Chiang Mai University Hospital Experience

Authors

  • Kirati Watcharachan Department of Surgery, Faculty of Medicine, Chiang Mai University
  • Pongsak Mahanupab Department of Pathology, Faculty of Medicine, Chiang Mai University

Keywords:

Location, parathyroid adenoma, primary hyperparathyroidism

Abstract

Background and Objective: To identify common locations of parathyroid adenomas in patients with primary hyperparathyroidism seen at Chiang Mai University Hospital.

Material and Method: A retrospective medical record review was performed to identify the location of parathyroid adenomas in patients who underwent parathyroidectomy with pathology report confirmation at Chiang Mai University Hospital from January 2005 to December 2014. The adenomas were grouped according to their position, into right superior, right inferior, left superior and left inferior.

Results: in terms of the position of adenomas were also reviewed. Results: The most common location of parathyroid adenomas was left inferior. In 23 patients, the left inferior location was seen in 12 patients (52%), the right inferior in 5 patients (22%), the left superior in 4 patients (17%) and the right superior in 2 patients (9%). According to MIBI scans, the left inferior was still the most common location of parathyroid adenomas (10/18 patients, 56%).

Conclusion: The most common location of parathyroid adenomas was the left inferior. This may help the surgeon identify an adenoma in primary hyperparathyroidism by providing a starting point, and perhaps decrease unnecessary neck exploration in patients with negative imaging studies.

References

1. Ruda JM, Hollenbeak CS, Stack BC Jr. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol Head Neck Surg 2005;132:359-72.

2. Sackett WR, Barraclough B, Reeve TS, Delbridge LW. Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 2002;137:1055-9.

3. Pappu S, Donovan P, Cheng D, Udelsman R. Sestamibi scans are not all created equally. Arch Surg 2005;140:383-6.

4. Spanu A, Falchi A, Manca A, et al. The usefulness of neck pinhole SPECT as a complementary tool to planar scintigraphy in primary and secondary hyperparathyroidism. J Nuclear Med 2004;45:40-8.

5. Solorzano CC, Carneiro-Pla DM, Irvin GL 3rd. Surgeonperformed ultrasonography as the initial and only localizing study in sporadic primary hyperparathyroidism. J Am Coll Surg 2006;202:18-24.

6. Siperstein A, Berber E, Barbosa GF, et al. Predicting the success of limited exploration for primary hyperparathyroidism using ultrasound, sestamibi, and intraoperative parathyroid hormone: analysis of 1158 cases. Ann Surg 2008;248:420-8.

7. Papier A, Kenig J, Barczynski M. Bilateral neck exploration with intraoperative iPTH assay in patients not eligible for minimally invasive parathyroidectomy. Przeglad Lekarski 2014;71:66-71.

8. Friedman K, Somervell H, Patel P, et al. Effect of calcium channel blockers on the sensitivity of preoperative (TC)-T-99M-MIBI SPECT for hyperparathyroidism. Surgery 2004; 136:1199-204.

9. Mehta NY, Ruda JM, Kapadia S, et al. Relationship of technetium Tc 99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue. Arch Otolaryngol Head Neck Surg 2005;131:493-8.

10. Marzouki HZ, Chavannes M, Tamilia M, et al. Location of parathyroid adenomas: 7-year experience. J Otolaryngol Head Neck Surg 2010;39:551-4.

11. Yazici P, Mihmanli M, Bozdag E, et al. Location of Parathyroid adenomas in Primary Hyperparathyroidism: Where to Look? World J Endoc Surg 2015;7:1-5.

12. Perrier ND, Edeiken B, Nunez R, et al. A novel nomenclature to classify parathyroid adenomas. World J Surg 2009;33:412-6.

13. Mazeh H, Stoll SJ, Robbins JB, Sippel RS, Chen H. Validation of the “Perrier” parathyroid adenoma location nomenclature. World J Surg 2012;36:612-6.

14. Moreno MA, Callender GG, Woodburn K, et al. Common locations of parathyroid adenomas. Ann Surg Oncol 2011;18:1047-51.

15. Adami S, Marcocci C, Gatti D. Epidemiology of primary hyperparathyroidism in Europe. J Bone Min Res 2002;17 Suppl 2:N18-23.

16. Bilezikian JP, Potts JT Jr, Fuleihan GH, et al. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol Metab 2002;87:5353-61.

17. Prasarttong-Osoth P, Wathanaoran P, Imruetaicharoenchoke W, Rojananin S. Primary hyperparathyroidism: 11-year experience in a single institute in Thailand. Int J Endocrinol 2012;2012:952426.

18. Barczynski M, Golkowski F, Nawrot I. The current status of intraoperative iPTH assay in surgery for primary hyperparathyroidism. Gland Surg 2015;4:36-43.
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Published

2016-03-31

How to Cite

1.
Watcharachan K, Mahanupab P. Location of Parathyroid Adenomas: Chiang Mai University Hospital Experience. Thai J Surg [Internet]. 2016 Mar. 31 [cited 2024 Nov. 22];37(1):28-32. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/219976

Issue

Vol. 37 No. 1 (2016): January - March

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.