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. 2014 Jan-Feb;80(1):29-34.
doi: 10.5935/1808-8694.20140008.

Localization of ectopic and supernumerary parathyroid glands in patients with secondary and tertiary hyperparathyroidism: surgical description and correlation with preoperative ultrasonography and Tc99m-Sestamibi scintigraphy

[Article in English, Portuguese]
José Santos Cruz de Andrade  1 , João Paulo Mangussi-Gomes  1 , Lillian Andrade da Rocha  2 , Monique Nakayama Ohe  3 , Marcello Rosano  1 , Murilo Catafesta das Neves  1 , Rodrigo de Oliveira Santos  1
Affiliations

Localization of ectopic and supernumerary parathyroid glands in patients with secondary and tertiary hyperparathyroidism: surgical description and correlation with preoperative ultrasonography and Tc99m-Sestamibi scintigraphy

[Article in English, Portuguese]
José Santos Cruz de Andrade et al. Braz J Otorhinolaryngol. 2014 Jan-Feb.

Abstract

Introduction: Hyperparathyroidism is an expected metabolic consequence of chronic kidney disease (CKD). Ectopic and/or supernumerary parathyroid glands (PT) may be the cause of surgical failure in patients undergoing total parathyroidectomy (PTX).

Aim: To define the locations of ectopic and supernumerary PT in patients with renal hyperparathyroidism and to correlate intraoperative findings with preoperative tests.

Materials and methods: A retrospective study was conducted with 166 patients submitted to PTX. The location of PT during surgery was recorded and classified as eutopic or ectopic. The preoperative localizations of PT found by ultrasonography (USG) and Tc99m-Sestamibi scintigraphy (MIBI) were subsequently compared with intraoperative findings.

Results: In the 166 patients studied, 664 PT were found. Five-hundred-seventy-seven (86.4%) glands were classified as eutopic and 91(13.6%) as ectopic. Eight supernumerary PT were found. The most common sites of ectopic PT were in the retroesophageal and thymic regions. Taken together, USG and MIBI did not identify 56 (61.5%) ectopic glands. MIBI was positive for 69,7% of all ectopic glands located in the mediastinal and thymic regions.

Conclusion: The presence of ectopic and supernumerary PT in patients with renal hyperparathyroidism is significant. Although preoperative imaging tests did not locate most of ectopic glands, MIBI may be important for identifying ectopic PT in the mediastinal and thymic regions.

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Figures

Figure 1
Figure 1
Intraoperative identification of ectopic parathyroids. The parathyroid glands that were not identified intraoperatively were also included. URPT, upper right parathyroid; LRPT, lower right parathyroid; ULPT, upper left parathyroid; LLPT, lower left parathyroid; 5th PT, 5th parathyroid (supernumerary).
See this image and copyright information in PMC

References

    1. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Am J Kidney Dis. 2007;49:S12–S154. - PubMed
    1. Gough I. Reoperative parathyroid surgery: the importance of ectopic location and multigland disease. ANZ J Surg. 2006;76:1048–1050. - PubMed
    1. Gomes E.M.S., Nunes R.C., Lacativa P.G.S., de Almeida M.H., Franco F.M., Leal C.T.S., et al. Ectopic and extranumerary parathyroid glands location in patients with hyperparathyroidism secondary to end stage renal disease. Acta Cir Bras. 2007;22:105–109. - PubMed
    1. Wang C. The anatomic basis of parathyroid surgery. Ann Surg. 1976;183:271–275. - PMC - PubMed
    1. Pattou F.N., Pellissier L.C., Noël C., Wambergue F., Huglo D.G., Proye C.A. Supernumerary parathyroid glands: frequency and surgical significance in treatment of renal hyperparathyroidism. World J Surg. 2000;24:1330–1334. - PubMed

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