ABSTRACT
Objective To investigate the feasibility of unilateral neck exploration for parathyroid adenoma. Methods The clinical data of preoperative image localization and intraoperative unilateral neck exploration of 15 cases of parathyroid adenoma from 1996 to 2002 in our hospital were analyzed retrospectively. Results Unilateral neck explorations of the 15 cases were performed successfully with the guidance of preoperative ultrasonography , CT, MRI and 99m Tc MIBI scans, and the treatment effect was satisfactory. Conclusion Unilateral neck exploration of parathyroid adenoma could be feasible if accurate preoperative image localizations are available.
ABSTRACT
Objective To summarize the experience for diagnosis and treatment of parathyroid carcinoma(PTC).Methods The clinical data of 6 patients with PTC were retrospectively analyzed.Results Five patients complained of primary hyperparathyroidism,3 patients had manifestations of palpable neck mass,4 patients were admitted for hypercalcemia with calcium level of(3.62?0.56)mmol/L,and in 4 patients the parathyroid hormone(PTH) level was higher than two fold of the normal upper limit.Frozen section histopathology established diagnosis in 3 patients,routine histopathology combined with immunohistochemistry established the diagnosis in 2 patients,and routine histopathology combined with immunohistochemistry and clinical data established the diagnosis in 1 patient.Parathyroidectomy and ipsilateral subtotal thyroidectomy was performed in 5 patients,who were followed up for 1-5 years,recurrence in 1 patient 3 years after operation;tumor resection alone was performed in 1 patient with parathyroid cancer complicated with multiple bone metastasis,and the patient died of MOF 16 days postoperation.Conclusions The diagnosis of PTC is difficult before operation.Routine blood examinations,blood PTH,99mTc-MIBI scintigraphy,ultrasonography,CT,observation of specimen,and frozen section histopathology during operation are helpful to diagnosis.The surgical procedure of choice is parathyroidectomy and ipsilateral subtotal thyroidectomy.