Ultrasound-Guided Laser Thermal Ablation for Parathyroid Adenomas: Analysis of Three Cases with a Three-Year Follow-Up

Adda, Guido; Scillitani, Alfredo; Epaminonda, Paolo; Lembo, Sergio Di; Motta, Fábio; Cecconi, Pietro; Vecchi, G.; Arosio, Maura; Chiodini, Iacopo

doi:10.1159/000092404

Cited by 20 publications

(17 citation statements)

References 11 publications

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“…Three kinds of thermal ablation -MWA, RFA, laser ablationhave proved their efficacy in patients with primary or secondary hyperparathyroidism [23,24]. Each has advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and its predictor in microwave ablation for severe secondary hyperparathyroidism in patients undergoing haemodialysis

Diao

Liu

Qian

et al. 2016

International Journal of Hyperthermia

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Section: Discussionmentioning

confidence: 99%

Efficacy and its predictor in microwave ablation for severe secondary hyperparathyroidism in patients undergoing haemodialysis

Diao

Liu

Qian

et al. 2016

International Journal of Hyperthermia

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“…Ultrasound-guided laser thermal ablation for parathyroid adenomas has recently been proposed by Adda et al [17]. …”

Section: Discussionmentioning

confidence: 99%

Primary Hyperparathyroidism in Neonates and Childhood

Mallet¹

2008

Horm Res Paediatr

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Objectives: Primary hyperparathyroidism (HP1) in childhood is thought to be extremely rare. Its exact incidence remains unknown, as do the characteristics of HP1. A retrospective study collection was conducted on cases supplied by members of the Working Group on Calcium Metabolism throughout France over a 20-year period (1984–2004), since the availability of the intact parathormone (iPTH) radioimmunoassay. Results: 55 cases were collected of which 11 were neonates. Among the 44 children and adolescents, there were 18 male and 26 female patients, ranging in age from 6 to 18 (mean 13) years. 83% were symptomatic and 43% had nephrolithiasis. Symptoms were associated with high serum calcium and inappropriate iPTH levels. Ultrasonography and technetium-labelled methoxyisobutylisonitrile scintigraphy are useful tools for the preoperative localization of adenomas, particularly in adolescents. Intraoperative iPTH assays are effective in minimizing invasive parathyroidectomy. All patients, except neonates, underwent surgery: 29 adenomas and 11 hyperplasias were found. Two multiple endocrine neoplasias (MENs) were subsequently discovered. Since the calcium-sensing receptor (CaSR) mutation was reported, the form of management in neonates has become more medical (intravenous diphosphonates) than surgical. On follow-up no recurrence was observed except for MEN. Conclusion: These national results reflect HP1 epidemiology. HP1 is a rare entity and appears to be a severe disease in terms of symptoms with regard to management. The use of molecular biology tests could be useful not only in neonatal cases (CaSR mutation) but also prior to surgery in children (MEN mutation).

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“…He had a markedly elevated PTH level (> 1,900 ng/L) and hypercalcaemia (8)(9)(10) Evidence in the form of higher survival rates, better local control, lower recurrence rates and complete radiological tumour response supports RFA as a procedure superior to ethanol ablation. (11,12) Furthermore, ethanol ablation requires periodic re-injections in order to achieve a complete cure.…”

Section: Casementioning

confidence: 99%

Percutaneous sonography-guided radiofrequency ablation in the management of parathyroid adenoma

Xu¹,

Ya²,

Xie³

et al. 2013

smedj

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C a s e R e p o r t e137 I NTRO D U C TIO NParathyroid adenoma is a major cause of primary hyperparathyroidism, with an incidence of 80%-85%.(1) Currently, t he primar y me t ho d of t reat ment is parathyroidectomy. (2,3) This method of treatment, however, may not be possible when there is a high surgical risk or contraindication for surgery, or when the patient is reticent to undergo surgical procedures. The latter being a concern raised mainly by women due to the possibility of a resulting postoperative scar. Hence, in most cases, parathyroidectomy is only performed on selected patients.With the swift development of minimally invasive and highly specific techniques, percutaneous sonography-guided radiofrequency ablation (RFA) therapy has been steadily progressing and yielding good clinical results.(4-7) While RFA has been used as a reasonably effective method to treat some primary and secondary tumours of the thyroid,lung (5,6) and liver, (7) the procedure is not limited to these organs. This report describes our experience with RFA in the treatment of parathyroid adenoma, and aims to assess the safety, effectiveness and durability of this procedure for the treatment of parathyroid adenoma. CA S E R EPO RT S Case 1A 50-year-old man presented to our hospital with a onemonth history of vomiting, general fatigue and bone pain. ABSTRACT Parathyroid adenoma is a major cause of primary hyperparathyroidism. Treatment usually involves the surgical removal of one or more parathyroid glands. However, specific localising techniques have boosted the development of nonsurgical, minimally invasive procedures, such as percutaneous radiofrequency ablation (RFA) under ultrasonographic guidance, which are gaining popularity as a method of treatment. This paper reports two male patients who presented with hypercalcaemia (highest serum calcium level 4.56 mmol/L and 4.57 mmol/L, respectively) and hyperparathyroidism (highest serum parathyroid hormone [PTH] level 772 ng/L and > 1,900 ng/L, respectively) due to solitary parathyroid adenoma. Four days after percutaneous RFA, the serum calcium levels in both patients decreased and PTH levels showed a significant decreasing trend. Both patients recovered well with normal levels of calcium and improvement of symptoms. Thus, we conclude that RFA may be a safe and effective therapeutic option in the treatment of parathyroid adenoma. Keywords: hypercalcaemia, intervention, parathyroid adenoma, radiofrequency ablationSingapore Med J 2013; 54(7): e137-e140 doi: 10.11622/smedj.2013092 Tc-sestamibi scintigraphy images before radiofrequency ablation show increased uptake of the radionuclide in the middle right lobe of the thyroid gland.

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Ultrasound-Guided Laser Thermal Ablation for Parathyroid Adenomas: Analysis of Three Cases with a Three-Year Follow-Up

Cited by 20 publications

References 11 publications

Efficacy and its predictor in microwave ablation for severe secondary hyperparathyroidism in patients undergoing haemodialysis

Efficacy and its predictor in microwave ablation for severe secondary hyperparathyroidism in patients undergoing haemodialysis

Primary Hyperparathyroidism in Neonates and Childhood

Percutaneous sonography-guided radiofrequency ablation in the management of parathyroid adenoma

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