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Impact of Adenoma Weight and Ectopic Location of Parathyroid Adenoma on Localization Study Results

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Abstract

Although the sensitivity of preoperative localization techniques is high for solitary parathyroid adenomas, negative imaging study results are inevitable. The weight and location of the parathyroid adenoma may contribute to the negative results. We aimed to study the impact of adenoma weight and ectopic location of the parathyroid adenoma on ultrasonography and sestamibi scan results. The patients were divided into two groups according to adenoma location. Group 1 consisted of 36 patients with ectopic location, and group 2 consisted of 149 patients with normal location. Parathyroid adenoma weight and the results of imaging studies were determined in all patients. Of 185 patients operated on for hyperparathyroidism, 36 (19.4%) had ectopic parathyroid glands. There was a positive correlation between adenoma weight and positive imaging studies, whereas ectopic location did not correlate with negative imaging study results. There was no significant difference between the ectopic adenoma ratio of patients with negative and positive imaging study results. The weight of the ectopic parathyroid adenoma was significantly lower in patients with negative imaging study results than in patients with positive imaging study results (p = 0.001). According to the analysis of variance, patients with higher-weight adenomas have positive imaging study results irrespective of ectopic location. For both normal and ectopic adenoma locations, adenoma weight was found only to be a factor that positively influences imaging study results.

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References

  1. Bilezikian JP, Silverberg SJ (2000) Clinical spectrum of primary hyperparathyroidism. Rev Endocr Metab Disord 1:237–245

    Article  PubMed  CAS  Google Scholar 

  2. Melton LJ (2002) The epidemiology of primary hyperparathyroidism in North America. J Bone Miner Res 17:12–17

    Google Scholar 

  3. Lal G, Clark OH (2003) Primary hyperparathyroidism: controversies in surgical management. Trends Endocrinol Metab 14:417–422

    Article  PubMed  CAS  Google Scholar 

  4. Sackett WR, Barraclough B, Reeve TS, et al (2002) Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 137:1055–1059

    Article  PubMed  Google Scholar 

  5. Siperstein A, Berber E, Mackey R, et al (2004) Prospective evaluation of sestamibi scan, ultrasonography, and rapid PTH to predict the success of limited exploration for sporadic primary hyperparathyroidism. Surgery 136:872–880

    Article  PubMed  Google Scholar 

  6. Smith JR, Oates ME (2004) Radionuclide imaging of the parathyroid glands: patterns, pearls, and pitfalls. Radiographics 24:1101–1115

    Article  PubMed  Google Scholar 

  7. Huppert BJ, Reading CC (2007) Parathyroid sonography: imaging and intervention. J Clin Ultrasound 35:144–155

    Google Scholar 

  8. Lo CY, Lang BH, Chan WF, et al (2007) A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism. Am J Surg 193:155–159

    Article  PubMed  CAS  Google Scholar 

  9. Mihai R, Gleeson F, Buley ID, et al (2006) Negative imaging studies for primary hyperparathyroidism are unavoidable: correlation of sestamibi and high-resolution ultrasound scanning with histological analysis in 150 patients. World J Surg 30:697–704

    Article  PubMed  Google Scholar 

  10. Mehta NY, Ruda JM, Kapadia S, et al (2005) Relationship of technetium Tc 99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue. Arch Otolaryngol Head Neck Surg 131:493–498

    Article  PubMed  Google Scholar 

  11. Pattou F, Torres G, Mondragon-Sanchez A, et al (1999) Correlation of parathyroid scanning and anatomy in 261 unselected patients with sporadic primary hyperparathyroidism. Surgery 126:1123–1131

    Article  PubMed  CAS  Google Scholar 

  12. Barraclough BM, Barraclough BH (2000) Ultrasound of the thyroid and parathyroid glands. World J Surg 24:158–165

    Article  PubMed  CAS  Google Scholar 

  13. Phitayakorn R, McHenry CR (2006) Incidence and location of ectopic abnormal parathyroid glands. Am J Surg 191:418–423

    Article  PubMed  Google Scholar 

  14. Haber RS, Chun K, Kim CK, et al (2002) Ultrasonography for preoperative localization of enlarged parathyroid glands in primary hyperparathyroidism: comparison with 99m technetium sestamibi scintigraphy. Clin Endocrinol (Oxf) 57:241–249

    Article  Google Scholar 

  15. Lumachi F, Zucchetta P, Varotto S, et al (1999) Noninvasive localization procedures in ectopic hyperfunctioning parathyroid tumors. Endocr Relat Cancer 6:123–125

    Article  PubMed  CAS  Google Scholar 

  16. Dyson M (1995) Endocrine system. In: Williams PL, (eds). Gray’s anatomy, 38th edition. Churchill Livingstone, New York, pp 1881–1907

    Google Scholar 

  17. Wang CA (1976) The anatomic basis of parathyroid surgery. Ann Surg 183:271–275

    Article  PubMed  CAS  Google Scholar 

  18. Bhansali A, Masoodi SR, Bhadada S, et al (2006) Ultrasonography in detection of single and multiple abnormal parathyroid glands in primary hyperparathyroidism: comparison with radionuclide scintigraphy and surgery. Clin Endocrinol (Oxf) 65:340–345

    Article  CAS  Google Scholar 

  19. Mariani G, Gulec SA, Rubello D, et al (2003) Preoperative localization and radioguided parathyroid surgery. J Nucl Med 44:1443–1458

    PubMed  Google Scholar 

  20. Stephen AE, Roth SI, Fardo DW, et al (2007) Predictors of an accurate preoperative sestamibi scan for single-gland parathyroid adenomas. Arch Surg 142:381–386

    Article  PubMed  Google Scholar 

  21. Miccoli P, Berti P (2001) Minimally invasive parathyroid surgery. Best Pract Res Clin Endocrinol Metab 15:139–147

    Article  PubMed  CAS  Google Scholar 

  22. Miccoli P, Berti P, Raffaelli M, et al (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043

    Article  PubMed  CAS  Google Scholar 

  23. Wang CA (1976) The anatomic basis of parathyroid surgery. Ann Surg 183:271–275

    Article  PubMed  CAS  Google Scholar 

  24. Vail AD, Coller FC (1967) The parathyroid glands: clinicopathologic correlation of parathyroid disease as found in 200 unselected autopsies. Mol Med 64:234–238

    CAS  Google Scholar 

  25. Kamaya A, Quon A, Jeffrey RB (2006) Sonography of the abnormal parathyroid gland. Ultrasound Q 22:253–262

    Article  PubMed  Google Scholar 

  26. Westreich RW, Brandwein M, Mechanick JI, et al (2003) Preoperative parathyroid localization: correlating false-negative technetium 99m sestamibi scans with parathyroid disease. Laryngoscope 113:567–572

    Article  PubMed  Google Scholar 

  27. Castellani M, Reschini E, Longari V, et al (2001) Role of Tc-99m sestamibi scintigraphy in the diagnosis and surgical decision-making process in primary hyperparathyroid disease. Clin Nucl Med 26:139–144

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Yeşim Erbil.

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Erbil, Y., Barbaros, U., Tükenmez, M. et al. Impact of Adenoma Weight and Ectopic Location of Parathyroid Adenoma on Localization Study Results. World J Surg 32, 566–571 (2008). https://doi.org/10.1007/s00268-007-9389-4

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