Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Sep;99(3):246-252.
doi: 10.1111/cen.14939. Epub 2023 Jun 7.

Parathyroid fine-needle aspiration with parathyroid hormone washout as a preoperative localisation of parathyroid adenoma-A retrospective study

Pinchas Klein  1   2 , Shibli Alsleibi  2   3 , Ohad Cohen  1   2 , Jacob Ilany  1   2 , Rina Hemi  1   2 , Ehud Barhod  1   2 , Iris Vered  1   2 , Ophir Winder  2   3 , Galit Avior  3   4 , Liana Tripto-Shklonik  1   2
Affiliations
Review

Parathyroid fine-needle aspiration with parathyroid hormone washout as a preoperative localisation of parathyroid adenoma-A retrospective study

Pinchas Klein et al. Clin Endocrinol (Oxf). 2023 Sep.

Abstract

Objective: The use of parathyroid lesion aspiration in preoperative adenoma localisation is controversial. Concerns have been raised regarding both immediate safety (hematoma, infection, alterations on a subsequent histologic preparate) and long-term safety (seeding). We aimed to evaluate the short- and long-term safety, and the efficacy, of parathyroid fine-needle aspiration with parathyroid hormone washout as a localisation modality of parathyroid adenoma in patients with primary hyperparathyroidism.

Design: A retrospective study.

Patients: The sample comprised 29 patients with primary hyperparathyroidism who underwent minimally invasive parathyroidectomy at a tertiary referral centre, following localisation with parathyroid hormone washout.

Measurements: We reviewed all parathyroid hormone washout procedures performed during 2011-2021. Clinical, biochemical, and imaging information; and cytology, surgery, and pathology reports were extracted from electronic medical records.

Results: Parathyroid hormone levels from the needle wash were 2.1-112.5 times the upper limit of the serum norm. Other than mild neck discomfort, no immediate procedure complications were documented. Fibrotic changes and necrosis were reported in two patients, with no effect on the final pathologic diagnosis or surgery course. No long-term complications (seeding, or parathyromatosis) were found. A total of 26 (90%) patients who were operated following a positive parathyroid hormone washout result were normocalcemic at the end of a mean 38.1-month follow-up period.

Conclusions: Parathyroid fine-needle aspiration with parathyroid hormone washout was accurate. Immediate, surgical, or delayed complications were not demonstrated in our series. This approach might be considered for selected patients.

Keywords: Technetium Tc 99 m Sestamibi; biopsy; fine needle; hyperparathyroidism; parathyroid hormone; parathyroid neoplasms; parathyroidectomy; ultrasonography.

PubMed Disclaimer

References

REFERENCES

    1. Kunstman JW, Kirsch JD, Mahajan A, Udelsman R. Parathyroid localization and implications for clinical management. J Clin Endocrinol Metab. 2013;98(3):902-912. doi:10.1210/jc.2012-3168
    1. Wilhelm SM, Wang TS, Ruan DT, et al. The American association of endocrine surgeons guidelines for definitive management of primary hyperparathyroidism. JAMA Surgery. 2016;151(10):959-968. doi:10.1001/jamasurg.2016.2310
    1. Marcocci C, Mazzeo S, Bruno-Bossio G, et al. Preoperative localization of suspicious parathyroid adenomas by assay of parathyroid hormone in needle aspirates. Eur J Endocrinol. 1998;139(1):72-77. doi:10.1530/eje.0.1390072
    1. Ince S, Emer O, Deveci S, et al. Complementary role of parathormone washout test to 99mTc-MIBI parathyroid scintigraphy and histopathologic analysis of cell types in parathyroid adenomas. Rev Esp Med Nucl Imagen Mol (Engl Ed). 2018;37(4):205-210. doi:10.1016/j.remn.2017.12.006
    1. Ozderya A, Temizkan S, Cetin K, Ozugur S, Gul AE, Aydin K. The results of parathyroid hormone assay in parathyroid aspirates in pre-operative localization of parathyroid adenomas for focused parathyroidectomy in patients with negative or suspicious technetium-99m-sestamibi scans. Endocrine Practice. 2017;23(9):1101-1106. doi:10.4158/EP171921.OR

Substances

LinkOut - more resources