Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1

Detalhes bibliográficos
Autor(a) principal: d'Alessandro,André Fernandes
Data de Publicação: 2012
Outros Autores: Montenegro,Fábio Luiz de Menezes, Brandão,Lenine Garcia, Lourenço Jr,Delmar Muniz, Toledo,Sérgio de Almeida, Cordeiro,Anói Castro
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista da Associação Médica Brasileira (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302012000300012
Resumo: OBJECTIVE: To evaluate frequency, anatomic presentation, and quantities of supernumerary parathyroids glands in patients with primary hyperparathyroidism (HPT1) associated with multiple endocrine neoplasia type 1 (MEN1), as well as the importance of thymectomy, and the benefits of localizing examinations for those glands. METHODS: Forty-one patients with hyperparathyroidism associated with MEN1 who underwent parathyroidectomy between 1997 and 2007 were retrospectively studied. The location and number of supernumerary parathyroids were reviewed, as well as whether cervical ultrasound and parathyroid SESTAMIBI scan (MIBI) were useful diagnostic tools. RESULTS: In five patients (12.2%) a supernumerary gland was identified. In three of these cases (40%), the glands were near the thyroid gland and were found during the procedure. None of the imaging examinations were able to detect supernumerary parathyroids. In one case, only the pathologic examination could find a microscopic fifth gland in the thymus. In the last case, the supernumerary gland was resected through a sternotomy after a recurrence of hyperparathyroidism, ten years after the initial four-gland parathyroidectomy without thymectomy. MIBI was capable of detecting this gland, but only in the recurrent setting. Cervical ultrasound did not detect any supernumerary glands. CONCLUSION: The frequency of supernumerary parathyroid gland in the HPT1/MEN1 patients studied (12.2%) was significant. Surgeons should be aware of the need to search for supernumerary glands during neck exploration, besides the thymus. Imaging examinations were not useful in the pre-surgical location of these glands, and one case presented a recurrence of hyperparathyroidism.
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spelling Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1multiple endocrine neoplasia type 1primary hyperparathyroidismparathyroid glandsultrasonographyparathyroidectomyOBJECTIVE: To evaluate frequency, anatomic presentation, and quantities of supernumerary parathyroids glands in patients with primary hyperparathyroidism (HPT1) associated with multiple endocrine neoplasia type 1 (MEN1), as well as the importance of thymectomy, and the benefits of localizing examinations for those glands. METHODS: Forty-one patients with hyperparathyroidism associated with MEN1 who underwent parathyroidectomy between 1997 and 2007 were retrospectively studied. The location and number of supernumerary parathyroids were reviewed, as well as whether cervical ultrasound and parathyroid SESTAMIBI scan (MIBI) were useful diagnostic tools. RESULTS: In five patients (12.2%) a supernumerary gland was identified. In three of these cases (40%), the glands were near the thyroid gland and were found during the procedure. None of the imaging examinations were able to detect supernumerary parathyroids. In one case, only the pathologic examination could find a microscopic fifth gland in the thymus. In the last case, the supernumerary gland was resected through a sternotomy after a recurrence of hyperparathyroidism, ten years after the initial four-gland parathyroidectomy without thymectomy. MIBI was capable of detecting this gland, but only in the recurrent setting. Cervical ultrasound did not detect any supernumerary glands. CONCLUSION: The frequency of supernumerary parathyroid gland in the HPT1/MEN1 patients studied (12.2%) was significant. Surgeons should be aware of the need to search for supernumerary glands during neck exploration, besides the thymus. Imaging examinations were not useful in the pre-surgical location of these glands, and one case presented a recurrence of hyperparathyroidism.Associação Médica Brasileira2012-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302012000300012Revista da Associação Médica Brasileira v.58 n.3 2012reponame:Revista da Associação Médica Brasileira (Online)instname:Associação Médica Brasileira (AMB)instacron:AMB10.1590/S0104-42302012000300012info:eu-repo/semantics/openAccessd'Alessandro,André FernandesMontenegro,Fábio Luiz de MenezesBrandão,Lenine GarciaLourenço Jr,Delmar MunizToledo,Sérgio de AlmeidaCordeiro,Anói Castroeng2012-06-21T00:00:00Zoai:scielo:S0104-42302012000300012Revistahttps://ramb.amb.org.br/ultimas-edicoes/#https://old.scielo.br/oai/scielo-oai.php||ramb@amb.org.br1806-92820104-4230opendoar:2012-06-21T00:00Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB)false
dc.title.none.fl_str_mv Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
title Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
spellingShingle Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
d'Alessandro,André Fernandes
multiple endocrine neoplasia type 1
primary hyperparathyroidism
parathyroid glands
ultrasonography
parathyroidectomy
title_short Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
title_full Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
title_fullStr Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
title_full_unstemmed Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
title_sort Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1
author d'Alessandro,André Fernandes
author_facet d'Alessandro,André Fernandes
Montenegro,Fábio Luiz de Menezes
Brandão,Lenine Garcia
Lourenço Jr,Delmar Muniz
Toledo,Sérgio de Almeida
Cordeiro,Anói Castro
author_role author
author2 Montenegro,Fábio Luiz de Menezes
Brandão,Lenine Garcia
Lourenço Jr,Delmar Muniz
Toledo,Sérgio de Almeida
Cordeiro,Anói Castro
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv d'Alessandro,André Fernandes
Montenegro,Fábio Luiz de Menezes
Brandão,Lenine Garcia
Lourenço Jr,Delmar Muniz
Toledo,Sérgio de Almeida
Cordeiro,Anói Castro
dc.subject.por.fl_str_mv multiple endocrine neoplasia type 1
primary hyperparathyroidism
parathyroid glands
ultrasonography
parathyroidectomy
topic multiple endocrine neoplasia type 1
primary hyperparathyroidism
parathyroid glands
ultrasonography
parathyroidectomy
description OBJECTIVE: To evaluate frequency, anatomic presentation, and quantities of supernumerary parathyroids glands in patients with primary hyperparathyroidism (HPT1) associated with multiple endocrine neoplasia type 1 (MEN1), as well as the importance of thymectomy, and the benefits of localizing examinations for those glands. METHODS: Forty-one patients with hyperparathyroidism associated with MEN1 who underwent parathyroidectomy between 1997 and 2007 were retrospectively studied. The location and number of supernumerary parathyroids were reviewed, as well as whether cervical ultrasound and parathyroid SESTAMIBI scan (MIBI) were useful diagnostic tools. RESULTS: In five patients (12.2%) a supernumerary gland was identified. In three of these cases (40%), the glands were near the thyroid gland and were found during the procedure. None of the imaging examinations were able to detect supernumerary parathyroids. In one case, only the pathologic examination could find a microscopic fifth gland in the thymus. In the last case, the supernumerary gland was resected through a sternotomy after a recurrence of hyperparathyroidism, ten years after the initial four-gland parathyroidectomy without thymectomy. MIBI was capable of detecting this gland, but only in the recurrent setting. Cervical ultrasound did not detect any supernumerary glands. CONCLUSION: The frequency of supernumerary parathyroid gland in the HPT1/MEN1 patients studied (12.2%) was significant. Surgeons should be aware of the need to search for supernumerary glands during neck exploration, besides the thymus. Imaging examinations were not useful in the pre-surgical location of these glands, and one case presented a recurrence of hyperparathyroidism.
publishDate 2012
dc.date.none.fl_str_mv 2012-06-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/S0104-42302012000300012
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Associação Médica Brasileira
publisher.none.fl_str_mv Associação Médica Brasileira
dc.source.none.fl_str_mv Revista da Associação Médica Brasileira v.58 n.3 2012
reponame:Revista da Associação Médica Brasileira (Online)
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instname_str Associação Médica Brasileira (AMB)
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institution AMB
reponame_str Revista da Associação Médica Brasileira (Online)
collection Revista da Associação Médica Brasileira (Online)
repository.name.fl_str_mv Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB)
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