Detection and diagnosis of parathyroid incidentalomas during thyroid sonography

Frasoldati, Andrea; Pesenti, Marialaura; Toschi, Elena; Azzarito, Clorinda; Zini, Michele; Valcavi, Roberto

doi:10.1002/(sici)1097-0096(199911/12)27:9<492::aid-jcu2>3.0.co;2-h

Cited by 43 publications

(30 citation statements)

References 26 publications

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“…Often parathyroid lesions are attached to the thyroid and thus will move on swallowing, making the distinction from thyroid nodules difficult 7 . Patients with both parathyroid and thyroid disease had a higher false‐positive rate and a lower positive‐predictive value when ultrasound was used in evaluating parathyroid disease 13,14 . Computed tomography and radionucleide scans have also been reported to be less sensitive in identifying parathyroid pathology with concomitant thyroid disease 7 …”

Section: Discussionmentioning

confidence: 99%

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Weymouth

Serpell

Chambers³

2003

ANZ Journal of Surgery

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Parathyroid and thyroid disease often occur simultaneously. Concomitant parathyroid pathology should be considered, even in the absence of biochemical and radiological evidence, at neck exploration for thyroid disease. Macroscopic identification of parathyroid disease at neck exploration can be difficult when within the thyroid gland capsule. Cytology and imaging of parathyroid adenomas may, on occasion, mimic follicular thyroid neoplasms.

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Section: Discussionmentioning

confidence: 99%

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Weymouth

Serpell

Chambers³

2003

ANZ Journal of Surgery

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“…Initially, Doppman et al [54] reported seven cases of enlarged parathyroids with measurement of both PTH and Tg in washout (Table 3). Later, several studies demonstrated the relevance to measure FNA-PTH to localize parathyroid adenomas [14,15,[48][49][50][51][52][53][55][56][57][58][59][60][61][62][63][64][65][66][67]. In these papers, FNA-PTH achieved a sensitivity ranging from 70% to 100% and a specificity from 75% to 100%.…”

Section: Measurement Of Pth In Fna Fluids From Suspicious Hyperplastimentioning

confidence: 99%

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Trimboli

D’Aurizio

Tozzoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Different imaging tools, circulating endocrine markers, and fine-needle aspiration (FNA) cytology are of great importance in the diagnosis and follow-up of different thyroid and parathyroid diseases. Sometimes, however, they are conflicting or inconclusive: interestingly, measuring endocrine markers (i.e. thyroglobulin, calcitonin, parathyroid hormone) in fluids from FNA proved to be a very useful complementary diagnostic tool in such cases. The determination of endocrine markers in fluids other than serum/ plasma has been developed in the last years. Although studies have reported overall satisfactory results, a good standardization of procedures has not yet been reached, and further efforts should be made in order to better define preanalytical, analytical, and post-analytical aspects. Here we reviewed critically the literature on the measurement of FNA endocrine markers, focusing on laboratory issues, such as preparation of the sample, choice of solution, and technical features of determination of these markers. Indeed, information for use of FNA-Tg, FNA-CT, and FNA-PTH in clinical practice was also provided.

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“…All patients had PTH washout, which confirmed the correct localization of the parathyroid tissue. Frasoldati and colleagues [13] showed that FNA-PTH washout more than 101 pg/mL had a 100% sensitivity and specificity for verification of parathyroid tissue. One patient from our current series underwent this procedure during her pregnancy and we reported recently a successful outcome in this patient [14].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings

Winters

Friedlander

Noureldine

et al. 2011

Minimally Invasive Surgery

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Background. Reoperative parathyroid surgery for primary hyperparathyroidism can be challenging. Numerous preoperative localization techniques have been employed to facilitate a more focused surgical exploration. This paper describes a novel, minimally invasive, and highly successful method of parathyroid localization. Methods. Patients with recurrent or persistent primary hyperparathyroidism underwent parathyroidectomy following CT scan or ultrasound-guided wire localization of the parathyroid. Accurate placement was confirmed by fine-needle aspiration with immunocytochemistry or PTH washout. The guide wire was left in situ to guide surgical excision of the gland. Curative resection was established by monitoring intact serum PTH levels after excision of the adenoma. Results. All ten patients underwent successful redo-targeted parathyroidectomy. Nine of the ten patients were discharged on the day of surgery. One patient was observed overnight due to transient postoperative hypocalcemia, which resolved with calcium supplementation. Conclusion. Placement of a localization wire via preoperative high-resolution ultrasound or CT can expedite reoperative parathyroid surgery. It allows identification of parathyroid adenoma via a minimally invasive approach, especially in cases where a sestamibi scan is inconclusive.

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Detection and diagnosis of parathyroid incidentalomas during thyroid sonography

Cited by 43 publications

References 26 publications

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings

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