Document Detail

Intrathyroid parathyroid adenoma in primary hyperparathyroidism: can it be predicted preoperatively?
MedLine Citation:
PMID:  17354026     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The role of cervical ultrasonography (US)-guided surgery for intrathyroid parathyroid adenoma in primary hyperparathyroidism is rarely reported. The aim of this study was to elucidate the role of cervical US in identifying this entity. METHODS: From 1996 to 2003, cervical explorations were performed in 178 patients (mean age 57 years) with primary hyperparathyroidism. High-resolution cervical US was performed in all of the patients. Patients' characteristics were reviewed to identify predictive factors for intrathyroid adenoma. RESULTS: Cervical US identified abnormal parathyroid glands in 163 of 178 patients, with a positive predictive value (PPV) of 100%. Six patients (3.4%) were found to have intrathyroid parathyroid adenomas (two in the superior parathyroid and four in the inferior parathyroid). Cervical US predicted this anomaly in four of six patients (67%) in whom the thyroid gland was not nodular and allowed total enucleation of the adenoma to be performed in three and subtotal thyroid loboisthmectomy in three; these operations were performed uneventfully and rapidly. The PPV in this anomaly was 80%. Thirteen patients required postoperative calcium supplementation for 2 to 4 months, and all were normocalcemic at the time of the last clinic visit, with follow-up varying from 12 to 96 months. On multivariable analysis, no factor predicted intrathyroid localization of parathyroid adenoma. CONCLUSIONS: The PPV of high-resolution cervical US for identifying an abnormal parathyroid gland was 100% in this series. It was 80% for predicting intrathyroid localization of the adenoma. This method allows us to shorten the operating time by guiding the exploration immediately toward the thyroid gland.
Bassam Abboud; Ghassan Sleilaty; Selim Ayoub; Kamal Hachem; Tarek Smayra; Claude Ghorra; Gerard Abadjian
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-27     Completed Date:  2007-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  817-23     Citation Subset:  IM    
Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Alfred Naccache Street, Beirut, Lebanon.
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MeSH Terms
Aged, 80 and over
Hyperparathyroidism, Primary / etiology*,  surgery
Middle Aged
Multivariate Analysis
Parathyroid Neoplasms / complications,  surgery*,  ultrasonography*
Predictive Value of Tests
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Statistics, Nonparametric
Treatment Outcome
Ultrasonography, Doppler, Color

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