Recurrent Renal Hyperparathyroidism Caused by Parathyromatosis

Matsuoka, Susumu; Tominaga, Yoshihiro; Sato, Tetsuhiko; Uno, Nobuaki; Goto, Norihiko; Katayama, Akio; Uchida, Kazuharu; Tsuzuki, Toyonori

doi:10.1007/s00268-006-0391-z

Cited by 45 publications

(60 citation statements)

References 34 publications

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“…Conversely, recurrent hyperparathyroidism has a similar percentage in the two surgical strategies (18.6% vs. 18.5%); it is strongly dependent on the length of follow-up, and the cause may be related to the hyperfunctioning of the tissue if an excessive amount has been left in place after SPTX, or to the presence of supernumerary glands in cases treated with TPTX. There is no evidence in the literature of persistent or recurrent HPT/MEN1 cases caused by parathyreomatosis, although such cases have been reported in sporadic primary HPT (1–2%) and secondary HPT (12%)(37)–(39). …”

Section: Introductionmentioning

confidence: 99%

Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy

Tonelli¹,

Giudici²,

Cavalli³

et al. 2012

Clinics

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Usually, primary hyperparathyroidism is the first endocrinopathy to be diagnosed in patients with multiple endocrine neoplasia type 1, and is also the most common one. The timing of the surgery and strategy in multiple endocrine neoplasia type 1/hyperparathyroidism are still under debate. The aims of surgery are to: 1) correct hypercalcemia, thus preventing persistent or recurrent hyperparathyroidism; 2) avoid persistent hypoparathyroidism; and 3) facilitate the surgical treatment of possible recurrences. Currently, two types of surgical approach are indicated: 1) subtotal parathyroidectomy with removal of at least 3–3½ glands; and 2) total parathyroidectomy with grafting of autologous parathyroid tissue. Transcervical thymectomy must be performed with both of these procedures. Unsuccessful surgical treatment of hyperparathyroidism is more frequently observed in multiple endocrine neoplasia type 1 than in sporadic hyperparathyroidism. The recurrence rate is strongly influenced by: 1) the lack of a pre-operative multiple endocrine neoplasia type 1 diagnosis; 2) the surgeon's experience; 3) the timing of surgery; 4) the possibility of performing intra-operative confirmation (histologic examination, rapid parathyroid hormone assay) of the curative potential of the surgical procedure; and, 5) the surgical strategy. Persistent hyperparathyroidism seems to be more frequent after subtotal parathyroidectomy than after total parathyroidectomy with autologous graft of parathyroid tissue. Conversely, recurrent hyperparathyroidism has a similar frequency in the two surgical strategies. To plan further operations, it is very helpful to know all the available data about previous surgery and to undertake accurate identification of the site of recurrence.

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Section: Introductionmentioning

confidence: 99%

Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy

Tonelli¹,

Giudici²,

Cavalli³

et al. 2012

Clinics

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“…Parathromatosis was originally described by Palmer et al 29 Medical management and reoperation for those patients are generally ineffective. Although sonography was reported to be the most useful modality for indentifying parathyromatosis, 30 no reports in the literature described the definite imaging appearance. 13 Our cases showed at least 3 scattered deep and superficial hypoechoic, hypervascular cervical nodules by color Doppler sonography, which did not completely corresponded to MIBI scanning.…”

Section: Discussionmentioning

confidence: 90%

Chemical Ablation of Recurrent and Persistent Secondary Hyperparathyroidism After Subtotal Parathyroidectomy

Chen

Lin

et al. 2011

Annals of Surgery

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“…The state of high impact parathormone levels (iPTH) continuing after surgery is called parathyromatosis [4][5][6][7]. Enlargement of the parathyroid tissue that is seeded or implanted on forearm is blamed for parathyromatosis.…”

Section: Introductionmentioning

confidence: 99%

“…Enlargement of the parathyroid tissue that is seeded or implanted on forearm is blamed for parathyromatosis. The frequency of parathyromatosis in forearm autotransplantations is reported between 0.11% and 58% [6,7]. Another cause of high iPTH level after total parathyroidectomy with autotransplantation is due to preanalytical differences.…”

Section: Introductionmentioning

confidence: 99%

False High Parathormone Levels Due to Preanalytical Differences in Patient With Parathyroid Gland Autotransplantation

Duran¹

2013

J Med Cases

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High parathormone (iPTH) values in the patients having parathyroid autotransplantations can be derived from parathyromatosis or preanalytical differences. In this report, we presented a patient with kidney failure and factitiously high iPTH levels. Because of tertiary hyperparathyroidism, total parathyroidectomy and 1/2 parathyroid tissue autotransplantation to brachioradial muscle in right forearm operation has been performed. Although he has been followed with high iPTH levels for a long time, he does not have parathyromatosis. iPTH level was found normal when blood samples were taken from the other arm. High iPTH levels are thought to be related to the place where the blood samples taken i.e., samples taken from the proximal region of autotransplantation, we recommend the blood sample should be taken from the contralateral or distal region of the autotransplantation in order to avoid misdiagnosis and unnecessary and incorrect procedures in patients with parathyroid autotransplantation.

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Recurrent Renal Hyperparathyroidism Caused by Parathyromatosis

Cited by 45 publications

References 34 publications

Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy

Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy

Chemical Ablation of Recurrent and Persistent Secondary Hyperparathyroidism After Subtotal Parathyroidectomy

False High Parathormone Levels Due to Preanalytical Differences in Patient With Parathyroid Gland Autotransplantation

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