Diagnosis and surgical treatment of parathyroid adenoma (24 case report)

Abstract

Objective

To summarize the experience in diagnosing and treating parathyroid adenoma.

Methods

Twenty —four patients were diagnosed with parathyroid adenoma and received parathyroidectomy in our hospital. Sixteen of them presented with hyperparathyroidism. The patients received ultrasounography, CT or^99mTc —MIBI to locate the tumor site. Serum concentrations of PTH and calcium were checked before the operation. All operations were performed under general anesthesia. The adenomas were resected and the four glands explored.

Results

All of the patients were cured and there was no mortality in our group. The symptoms of hyperparathyroidism remitted to various degrees after the operation. PTH dropped to the normal range 2 days after operation. Serum calcium concentrations declined to different levels from the first day after operation. Seven patients developed hypocalcemia post-operation but recovered by injection of calcium gluconate. Only one of the patients with parathyroid adenoma recurred 2 years after the operation and was found to have malignancy of the parathyroid adenoma.

Conclusion

Not all the patients with parathyroid adenoma had clinical manifestations. The CT and^99mTc —MIBI were more accurate than ultrasounography in locating the adenoma. The four glands should be explored during the operation. Protecting the recurrent laryngeal nerve from being injuried and maintaning secure hemastasis were most important.