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World Journal of Surgery

, Volume 32, Issue 11, pp 2516–2519 | Cite as

Incidence of Parathyroid Glands Located in Thymus in Patients with Renal Hyperparathyroidism

  • Nobuaki Uno
  • Yoshihiro Tominaga
  • Susumu Matsuoka
  • Toyonori Tsuzuki
  • Shuichi Shimabukuro
  • Tetsuhiko Sato
  • Norihiko Goto
  • Takaharu Nagasaka
  • Akio Katayama
  • Kazuharu Uchida
Article

Abstract

Background

Parathyroid glands are frequently located in thymus, and it is essential to resect thymic tissue from the neck incision, especially in surgery for renal hyperparathyroidism (HPT).

Methods

In this study, we evaluated the incidence, location, and type of intrathymic parathyroid glands in 902 patients who underwent initial parathyroidectomy (PTx) for advanced renal HPT in our department. Removal of the thymic tongues on both sides was routinely performed from the neck incision, and the thymic tissue was carefully examined both macroscopically and microscopically.

Results

Of the 902 patients in the study, 269 had only inferior parathyroid glands in the thymus, in 62 patients only supernumerary glands were found in the thymic tongue, and in 78 patients both inferior and supernumerary glands were present in thymic tissue. Therefore the incidence of patients with intrathymic glands was 45.3% (269 + 62 + 78 = 409/902). In 129 (92.1%) of 140 patients with supernumerary glands in the thymic tongue, these glands were detected only on histopathological examination, and about half of them were classified as the parathyromatosis type.

Conclusions

In the human, parathyroid glands might be located in the thymus in about 50%. If the inferior gland/glands cannot be found around the inferior pole of thyroid lobe, it is very important to search for glands in the thymic tongue. Moreover, to avoid missing supernumerary glands, removal of the thymic tongue on both sides is essential in surgery for renal HPT.

Keywords

Chronic Kidney Disease Parathyroid Gland Parathyroid Tissue Thymic Tissue Innominate Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors are grateful to Professor Henry Johansson, Department of Surgery, Uppsala University Hospital, Sweden, for his kind advice.

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Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Nobuaki Uno
    • 1
  • Yoshihiro Tominaga
    • 1
  • Susumu Matsuoka
    • 1
  • Toyonori Tsuzuki
    • 2
  • Shuichi Shimabukuro
    • 1
  • Tetsuhiko Sato
    • 1
  • Norihiko Goto
    • 1
  • Takaharu Nagasaka
    • 1
  • Akio Katayama
    • 1
  • Kazuharu Uchida
    • 1
  1. 1.Department of Transplant and Endocrine SurgeryNagoya Daini Red Cross HospitalNagoyaJapan
  2. 2.Department of PathologyNagoya Daini Red Cross HospitalNagoyaJapan

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