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. 2008 Dec;144(6):878-83; discussion 883-4.
doi: 10.1016/j.surg.2008.08.031.

The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism

Anathea C Powell  1 , H Richard Alexander, James F Pingpank, Seth M Steinberg, Monica Skarulis, David L Bartlett, Sunita Agarwal, Craig Cochran, Geoffrey Seidel, Douglas Fraker, Marybeth S Hughes, Robert T Jensen, Stephen J Marx, Steven K Libutti
Affiliations

The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism

Anathea C Powell et al. Surgery. 2008 Dec.

Abstract

Background: Operation for multiple endocrine neoplasia (MEN)1-related hyperparathyroidism (HPT) includes a neck exploration with resection of 3.5 or 4 parathyroid glands and transcervical thymectomy (TCT). We reviewed our experience with initial operation for primary HPT to determine the outcome and utility of routine TCT.

Methods: All patients with MEN1 who underwent initial neck exploration from 1993 to 2007 under an institutional review board-approved protocol were reviewed.

Results: We identified 66 patients with initial operation for HPT in MEN1. In 34 patients, 4 glands were found; in 32 patients, <4 glands were found. In 2 of the 34 (6%) and 17 of the 32 (53%), intrathymic parathyroid tissue was found on permanent pathology. No thymic carcinoid tissue was found in any specimen.

Conclusion: These data highlight the importance of performing TCT when <4 entopic parathyroid glands are found at first operation.

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Figures

Figure 1
Figure 1
Analysis of Patients by Number of Glands Found in Neck Exploration. PT = parathyroid
See this image and copyright information in PMC

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