Localization of ectopic and supernumerary parathyroid glands in patients with secondary and tertiary hyperparathyroidism: surgical description and correlation with preoperative ultrasonography and Tc99m-Sestamibi scintigraphy✩✩Please cite this article as: Andrade JS, Mangussi-Gomes J, Rocha LA, Ohe MN, Rosano M, Neves MC, et al. Localization of ectopic and supernumerary parathyroid glands in patients with secondary and tertiary hyperparathyroidism: Surgical description and correlation with preoperative ult

Andrade, José Santos Cruz de; Mangussi‐Gomes, João; Rocha, Lillian Andrade da; Ohe, Monique Nakayama; Rosano, Marcello; Neves, Murilo Catafesta das; Santos, Rodrigo de Oliveira

doi:10.5935/1808-8694.20140008

Cited by 34 publications

(25 citation statements)

References 17 publications

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“…Still, we do not encountered higher levels of recurrence in comparison with authors who perform thymectomy routinely, as shown in a previous publication. 19 …”

Section: Discussionmentioning

confidence: 99%

Initial surgical results of 500 Parathyroidectomies for Hyperparathyroidism related to chronic kidney disease - mineral and bone disorder

et al. 2018

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“…Still, we do not encountered higher levels of recurrence in comparison with authors who perform thymectomy routinely, as shown in a previous publication. 19 …”

Section: Discussionmentioning

confidence: 99%

Initial surgical results of 500 Parathyroidectomies for Hyperparathyroidism related to chronic kidney disease - mineral and bone disorder

et al. 2018

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“…[ 30 ] Although ultrasound and radionuclide scanning technology have matured a lot over the last few years, the failure in locating the entire parathyroid tissue still remains. [ 31 ] Tissue traction often results in parathyroid ectopic. [ 32 ] Therefore, preoperative parathyroid localization is imperative.…”

Section: Discussionmentioning

confidence: 99%

Total parathyroidectomy with forearm auto-transplantation improves the quality of life and reduces the recurrence of secondary hyperparathyroidism in chronic kidney disease patients

Li¹,

Xiao²,

Hu³

et al. 2017

Medicine

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Background:Our study aims to explore the effect of total parathyroidectomy (PTX) with forearm autotransplantation (FAT) on the quality of life and recurrence of secondary hyperparathyroidism (SHPT) in chronic kidney disease patients.Methods:A total of 104 chronic kidney disease patients with SHPT were enrolled and divided into the PTX (n = 62) and PTX + FAT (n = 42) groups. The operation efficacy was evaluated by analyzing preoperative and postoperative values, including levels of intact parathyroid hormone (iPTH), serum phosphorus, serum calcium, alkaline phosphatase (ALP), calcium-phosphorus product, signs and symptoms, and MOS 36-item short-form health survey (SF-36) scores. Moreover, complications and recurrences were followed up for 12 months after the operation. Binary logistic regression was to present the risk factors for the recurrence of chronic kidney disease patients with SHPT.Results:Compared with the preoperative values, the PTX and PTX + FAT groups showed decrease postoperative levels of iPTH, serum phosphorus, serum calcium, calcium-phosphorus product, bone pain, and skin pruritus at all time periods. The PTX and PTX + FAT groups demonstrated decreased ALP, fracture or deformity, and coronary artery calcification at 1 month, decreased short stature at 3 months after the operation but increased SF-36 score after operation. Compared with the PTX group, the level of iPTH decreased and the levels of serum calcium, calcium-phosphorus product increased at 3, 6, and 12 months after the operation in the PTX + FAT group. The levels of ALP, fracture or deformity, short stature, and SF-36 decreased separately at 1 week and 6 and 12 months after the operation, along with the decrease of coronary artery calcification and the recurrence rate, respectively, at 6 and 12 months after the operation in the PTX + FAT group when compared with those in the PTX group. Logistic regression analysis evidenced that the preoperative iPTH level, SF-36 score, and operation type were the risk factors for the recurrence of chronic kidney disease with SHPT.Conclusion:Total PTX combined with FAT is more effective in improving the quality of life and reducing the recurrence of chronic kidney disease with SHPT than PTX alone.

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“…Thirdly, an ectopic parathyroid gland located in the anterior mediastinum was identified as the culprit of hypercalcemia and tertiary HPT in this case. However, the localization of the ectopic parathyroid glands vary diversely, and the most common sites are in the retroesophageal and thymic regions [7]. Notably, scintigraphy with 99mTc-Sestamibi should be performed in cases of recurrence and persistence of hyperparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

Refractory hypercalcemia due to an ectopic mediastinal parathyroid gland in a hemodialysis patient: a case report

Shen

Fei

2019

BMC Nephrol

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Background Hypercalcemia crisis is a complex disorder rarely induced by tertiary hyperparathyroidism, which clinically presents as nonsuppressible parathyroid hyperplasia with persistent increased PTH levels and hypercalcemia. It is one of the major risk factors of morbidity and mortality in end-stage renal disease. Parathyroidectomy should be in consideration in dialysis patients with severe hyperparathyroidism who are refractory to medical therapy. The implications and consequences of it, however, are not fully understood. Case presentation We present a case of a 70 year-old man disturbed by gastrointestinal manifestations due to hypercalcaemic crisis. The patient had longstanding hypercalcaemia and hyperparathyrodism refractory to calcimimetics, calcitonin, hormone and haemodialysis. A ectopic parathyroid gland in anterior mediastinum was found and elucidated by Tc-99 m scan. Futhermore, a video-assisted thoracoscopic parathyroidectomy was performed. Histologically, the tumour consisted of densely arranged chief cells immunohistochemically positive for PTH antigens. Consequently, calcium and parathormone were declining stably without any complications. Conclusions On account of refractory hypercalcemia and hyperparathyroidism, radionuclide scanning is useful in the diagnosis of ectopic parathyroid gland. it is of great significance for multidisciplinary therapy combing anesthesia, surgical, endocrinology and nephrology staff.

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Abstract: The presence of ectopic and supernumerary PT in patients with renal hyperparathyroidism is significant. Although preoperative imaging tests did not locate most of ectopic glands, MIBI may be important for identifying ectopic PT in the mediastinal and thymic regions.

Cited by 34 publications

References 17 publications

Initial surgical results of 500 Parathyroidectomies for Hyperparathyroidism related to chronic kidney disease - mineral and bone disorder

Initial surgical results of 500 Parathyroidectomies for Hyperparathyroidism related to chronic kidney disease - mineral and bone disorder

Total parathyroidectomy with forearm auto-transplantation improves the quality of life and reduces the recurrence of secondary hyperparathyroidism in chronic kidney disease patients

Refractory hypercalcemia due to an ectopic mediastinal parathyroid gland in a hemodialysis patient: a case report

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