Document Detail

Ectopic and extranumerary parathyroid glands location in patients with hyperparathyroidism secondary to end stage renal disease.
MedLine Citation:
PMID:  17375215     Owner:  NLM     Status:  MEDLINE    
Supranumerary or ectopic parathyroid glands are the main cause of persistent hyperparathyroidism (HPT) in patients with end stage renal disease (ESRD) submitted to parathyroidectomy (PTx). PURPOSE: To evaluate the prevalence and location of parathyroid glands in these patients. METHODS: Thirty-five patients with ESRD and severe secondary hyperparathyroidism (HPT2) had been submitted to total PTx at HUCFF from December 2001 to July 2005. Surgery was always performed by the same surgeon, who described in details the location of the glands. RESULTS: Sixteen patients (45.7%) had ectopic glands, which were also extranumerary in five of them (14.3%). The most common locations were the thyroid parenchyma (33.3%), thyroid-thymus conduit (18.5%), and thymus (14.8%). Before PTx, the sensibility of ultrasonography and scintigraphy with technetium-99m Sestamibi was low (48.3% and 35.3%, respectively). Moreover, 51.4% of the nodules found at US were thyroid nodules. However, 99mTc-Sestamibi was useful to identify ectopic glands in those two patients with persistent HPT after PTx. CONCLUSION: The presence of extranumerary and ectopic parathyroid glands in HPT2 is sufficiently important to justify their exhaustive search. As the preoperative image exams present low sensibility to locate them, it is necessary to develop an exploratory routine embracing the most common sites of location.
Elaine Maria Santos Gomes; Reinaldo Cavalcante Nunes; Paulo Gustavo Sampaio Lacativa; Mirella Hansen de Almeida; Felipe Malzac Franco; Christianne Toledo Souza Leal; Pedro José de Mattos Patrício Filho; Maria Lucia Fleiuss Farias; Manuel Domingos da Cruz Gonçalves
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cirúrgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia     Volume:  22     ISSN:  0102-8650     ISO Abbreviation:  Acta Cir Bras     Publication Date:    2007 Mar-Apr
Date Detail:
Created Date:  2007-03-21     Completed Date:  2008-06-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9103983     Medline TA:  Acta Cir Bras     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  105-9     Citation Subset:  IM    
Postgraduation Program in Endocrinology, Universidade Federal do Rio de Janeiro, Brazil.
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MeSH Terms
Choristoma / diagnosis*,  radionuclide imaging,  surgery
Hyperparathyroidism, Secondary / radionuclide imaging,  surgery*
Kidney Failure, Chronic / complications*
Lymphatic Diseases / diagnosis*,  radionuclide imaging,  surgery
Middle Aged
Parathyroid Glands*
Parathyroid Hormone / blood
Prospective Studies
Radiopharmaceuticals / diagnostic use
Technetium Tc 99m Sestamibi / diagnostic use
Thymus Gland
Thyroid Diseases / diagnosis*,  radionuclide imaging,  surgery
Reg. No./Substance:
0/Parathyroid Hormone; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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