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Published in: World Journal of Surgery 4/2008

01-04-2008

Impact of Adenoma Weight and Ectopic Location of Parathyroid Adenoma on Localization Study Results

Authors: Yeşim Erbil, Umut Barbaros, Mustafa Tükenmez, Halim İşsever, Artür Salmaslıoğlu, Işık Adalet, Selçuk Özarmağan, Serdar Tezelman

Published in: World Journal of Surgery | Issue 4/2008

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Abstract

Although the sensitivity of preoperative localization techniques is high for solitary parathyroid adenomas, negative imaging study results are inevitable. The weight and location of the parathyroid adenoma may contribute to the negative results. We aimed to study the impact of adenoma weight and ectopic location of the parathyroid adenoma on ultrasonography and sestamibi scan results. The patients were divided into two groups according to adenoma location. Group 1 consisted of 36 patients with ectopic location, and group 2 consisted of 149 patients with normal location. Parathyroid adenoma weight and the results of imaging studies were determined in all patients. Of 185 patients operated on for hyperparathyroidism, 36 (19.4%) had ectopic parathyroid glands. There was a positive correlation between adenoma weight and positive imaging studies, whereas ectopic location did not correlate with negative imaging study results. There was no significant difference between the ectopic adenoma ratio of patients with negative and positive imaging study results. The weight of the ectopic parathyroid adenoma was significantly lower in patients with negative imaging study results than in patients with positive imaging study results (p = 0.001). According to the analysis of variance, patients with higher-weight adenomas have positive imaging study results irrespective of ectopic location. For both normal and ectopic adenoma locations, adenoma weight was found only to be a factor that positively influences imaging study results.
Literature
1.
go back to reference Bilezikian JP, Silverberg SJ (2000) Clinical spectrum of primary hyperparathyroidism. Rev Endocr Metab Disord 1:237–245PubMedCrossRef Bilezikian JP, Silverberg SJ (2000) Clinical spectrum of primary hyperparathyroidism. Rev Endocr Metab Disord 1:237–245PubMedCrossRef
2.
go back to reference Melton LJ (2002) The epidemiology of primary hyperparathyroidism in North America. J Bone Miner Res 17:12–17 Melton LJ (2002) The epidemiology of primary hyperparathyroidism in North America. J Bone Miner Res 17:12–17
3.
go back to reference Lal G, Clark OH (2003) Primary hyperparathyroidism: controversies in surgical management. Trends Endocrinol Metab 14:417–422PubMedCrossRef Lal G, Clark OH (2003) Primary hyperparathyroidism: controversies in surgical management. Trends Endocrinol Metab 14:417–422PubMedCrossRef
4.
go back to reference Sackett WR, Barraclough B, Reeve TS, et al (2002) Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 137:1055–1059PubMedCrossRef Sackett WR, Barraclough B, Reeve TS, et al (2002) Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 137:1055–1059PubMedCrossRef
5.
go back to reference Siperstein A, Berber E, Mackey R, et al (2004) Prospective evaluation of sestamibi scan, ultrasonography, and rapid PTH to predict the success of limited exploration for sporadic primary hyperparathyroidism. Surgery 136:872–880PubMedCrossRef Siperstein A, Berber E, Mackey R, et al (2004) Prospective evaluation of sestamibi scan, ultrasonography, and rapid PTH to predict the success of limited exploration for sporadic primary hyperparathyroidism. Surgery 136:872–880PubMedCrossRef
6.
go back to reference Smith JR, Oates ME (2004) Radionuclide imaging of the parathyroid glands: patterns, pearls, and pitfalls. Radiographics 24:1101–1115PubMedCrossRef Smith JR, Oates ME (2004) Radionuclide imaging of the parathyroid glands: patterns, pearls, and pitfalls. Radiographics 24:1101–1115PubMedCrossRef
7.
go back to reference Huppert BJ, Reading CC (2007) Parathyroid sonography: imaging and intervention. J Clin Ultrasound 35:144–155 Huppert BJ, Reading CC (2007) Parathyroid sonography: imaging and intervention. J Clin Ultrasound 35:144–155
8.
go back to reference Lo CY, Lang BH, Chan WF, et al (2007) A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism. Am J Surg 193:155–159PubMedCrossRef Lo CY, Lang BH, Chan WF, et al (2007) A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism. Am J Surg 193:155–159PubMedCrossRef
9.
go back to reference Mihai R, Gleeson F, Buley ID, et al (2006) Negative imaging studies for primary hyperparathyroidism are unavoidable: correlation of sestamibi and high-resolution ultrasound scanning with histological analysis in 150 patients. World J Surg 30:697–704PubMedCrossRef Mihai R, Gleeson F, Buley ID, et al (2006) Negative imaging studies for primary hyperparathyroidism are unavoidable: correlation of sestamibi and high-resolution ultrasound scanning with histological analysis in 150 patients. World J Surg 30:697–704PubMedCrossRef
10.
go back to reference Mehta NY, Ruda JM, Kapadia S, et al (2005) Relationship of technetium Tc 99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue. Arch Otolaryngol Head Neck Surg 131:493–498PubMedCrossRef Mehta NY, Ruda JM, Kapadia S, et al (2005) Relationship of technetium Tc 99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue. Arch Otolaryngol Head Neck Surg 131:493–498PubMedCrossRef
11.
go back to reference Pattou F, Torres G, Mondragon-Sanchez A, et al (1999) Correlation of parathyroid scanning and anatomy in 261 unselected patients with sporadic primary hyperparathyroidism. Surgery 126:1123–1131PubMedCrossRef Pattou F, Torres G, Mondragon-Sanchez A, et al (1999) Correlation of parathyroid scanning and anatomy in 261 unselected patients with sporadic primary hyperparathyroidism. Surgery 126:1123–1131PubMedCrossRef
12.
go back to reference Barraclough BM, Barraclough BH (2000) Ultrasound of the thyroid and parathyroid glands. World J Surg 24:158–165PubMedCrossRef Barraclough BM, Barraclough BH (2000) Ultrasound of the thyroid and parathyroid glands. World J Surg 24:158–165PubMedCrossRef
13.
go back to reference Phitayakorn R, McHenry CR (2006) Incidence and location of ectopic abnormal parathyroid glands. Am J Surg 191:418–423PubMedCrossRef Phitayakorn R, McHenry CR (2006) Incidence and location of ectopic abnormal parathyroid glands. Am J Surg 191:418–423PubMedCrossRef
14.
go back to reference Haber RS, Chun K, Kim CK, et al (2002) Ultrasonography for preoperative localization of enlarged parathyroid glands in primary hyperparathyroidism: comparison with 99m technetium sestamibi scintigraphy. Clin Endocrinol (Oxf) 57:241–249CrossRef Haber RS, Chun K, Kim CK, et al (2002) Ultrasonography for preoperative localization of enlarged parathyroid glands in primary hyperparathyroidism: comparison with 99m technetium sestamibi scintigraphy. Clin Endocrinol (Oxf) 57:241–249CrossRef
15.
go back to reference Lumachi F, Zucchetta P, Varotto S, et al (1999) Noninvasive localization procedures in ectopic hyperfunctioning parathyroid tumors. Endocr Relat Cancer 6:123–125PubMedCrossRef Lumachi F, Zucchetta P, Varotto S, et al (1999) Noninvasive localization procedures in ectopic hyperfunctioning parathyroid tumors. Endocr Relat Cancer 6:123–125PubMedCrossRef
16.
go back to reference Dyson M (1995) Endocrine system. In: Williams PL, (eds). Gray’s anatomy, 38th edition. Churchill Livingstone, New York, pp 1881–1907 Dyson M (1995) Endocrine system. In: Williams PL, (eds). Gray’s anatomy, 38th edition. Churchill Livingstone, New York, pp 1881–1907
18.
go back to reference Bhansali A, Masoodi SR, Bhadada S, et al (2006) Ultrasonography in detection of single and multiple abnormal parathyroid glands in primary hyperparathyroidism: comparison with radionuclide scintigraphy and surgery. Clin Endocrinol (Oxf) 65:340–345CrossRef Bhansali A, Masoodi SR, Bhadada S, et al (2006) Ultrasonography in detection of single and multiple abnormal parathyroid glands in primary hyperparathyroidism: comparison with radionuclide scintigraphy and surgery. Clin Endocrinol (Oxf) 65:340–345CrossRef
19.
go back to reference Mariani G, Gulec SA, Rubello D, et al (2003) Preoperative localization and radioguided parathyroid surgery. J Nucl Med 44:1443–1458PubMed Mariani G, Gulec SA, Rubello D, et al (2003) Preoperative localization and radioguided parathyroid surgery. J Nucl Med 44:1443–1458PubMed
20.
go back to reference Stephen AE, Roth SI, Fardo DW, et al (2007) Predictors of an accurate preoperative sestamibi scan for single-gland parathyroid adenomas. Arch Surg 142:381–386PubMedCrossRef Stephen AE, Roth SI, Fardo DW, et al (2007) Predictors of an accurate preoperative sestamibi scan for single-gland parathyroid adenomas. Arch Surg 142:381–386PubMedCrossRef
21.
go back to reference Miccoli P, Berti P (2001) Minimally invasive parathyroid surgery. Best Pract Res Clin Endocrinol Metab 15:139–147PubMedCrossRef Miccoli P, Berti P (2001) Minimally invasive parathyroid surgery. Best Pract Res Clin Endocrinol Metab 15:139–147PubMedCrossRef
22.
go back to reference Miccoli P, Berti P, Raffaelli M, et al (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043PubMedCrossRef Miccoli P, Berti P, Raffaelli M, et al (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043PubMedCrossRef
24.
go back to reference Vail AD, Coller FC (1967) The parathyroid glands: clinicopathologic correlation of parathyroid disease as found in 200 unselected autopsies. Mol Med 64:234–238 Vail AD, Coller FC (1967) The parathyroid glands: clinicopathologic correlation of parathyroid disease as found in 200 unselected autopsies. Mol Med 64:234–238
25.
go back to reference Kamaya A, Quon A, Jeffrey RB (2006) Sonography of the abnormal parathyroid gland. Ultrasound Q 22:253–262PubMedCrossRef Kamaya A, Quon A, Jeffrey RB (2006) Sonography of the abnormal parathyroid gland. Ultrasound Q 22:253–262PubMedCrossRef
26.
go back to reference Westreich RW, Brandwein M, Mechanick JI, et al (2003) Preoperative parathyroid localization: correlating false-negative technetium 99m sestamibi scans with parathyroid disease. Laryngoscope 113:567–572PubMedCrossRef Westreich RW, Brandwein M, Mechanick JI, et al (2003) Preoperative parathyroid localization: correlating false-negative technetium 99m sestamibi scans with parathyroid disease. Laryngoscope 113:567–572PubMedCrossRef
27.
go back to reference Castellani M, Reschini E, Longari V, et al (2001) Role of Tc-99m sestamibi scintigraphy in the diagnosis and surgical decision-making process in primary hyperparathyroid disease. Clin Nucl Med 26:139–144PubMedCrossRef Castellani M, Reschini E, Longari V, et al (2001) Role of Tc-99m sestamibi scintigraphy in the diagnosis and surgical decision-making process in primary hyperparathyroid disease. Clin Nucl Med 26:139–144PubMedCrossRef
Metadata
Title
Impact of Adenoma Weight and Ectopic Location of Parathyroid Adenoma on Localization Study Results
Authors
Yeşim Erbil
Umut Barbaros
Mustafa Tükenmez
Halim İşsever
Artür Salmaslıoğlu
Işık Adalet
Selçuk Özarmağan
Serdar Tezelman
Publication date
01-04-2008
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 4/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-007-9389-4

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