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Case Reports
. 2023 Sep 19:14:1175377.
doi: 10.3389/fendo.2023.1175377. eCollection 2023.

Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report

Zhoujun Liu  1 , Yueting Zhao  1 , Xue Han  1 , Xin Hu  1 , Yuzhi Zhang  2 , Lan Xu  3 , Guofang Chen  1   4 , Chao Liu  1   4 , Shuhang Xu  1
Affiliations
Case Reports

Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report

Zhoujun Liu et al. Front Endocrinol (Lausanne). .

Abstract

Background: Multiple endocrine neoplasia type 1 (MEN1) is an inherited endocrine syndrome caused by the mutation in the tumor suppressor gene MEN1. The recurrence rate of primary hyperparathyroidism (PHPT) in patients with MEN1 after parathyroidectomy remains high, and the management of recurrent hyperparathyroidism is still challenging.

Case presentation: We reported a 44-year-old woman with MEN1 combined with PHPT who was diagnosed through genetic screening of the patient and her family members. After parathyroidectomy to remove one parathyroid gland, the patient suffered from persistent high levels of serum calcium and parathyroid hormone, which returned to normal at up to 8 months after ultrasound-guided microwave ablation (MWA) for bilateral parathyroid glands, suggesting an acceptable short-term prognosis.

Conclusion: Ultrasound-guided MWA for parathyroid nodules may be an effective therapeutic strategy for recurrent PHPT in MEN1 patients.

Keywords: case report; microwave ablation; multiple endocrine neoplasia; primary hyperparathyroidism; recurrence.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Abdominal plain and contrast MRI scans of the pancreas showed a lesion occupying the tail of the pancreas. (B) Abdominal plain and contrast MRI scans of the pancreas showed a lesion occupying the right adrenal gland and suspected as adenoma. (C) Histopathological image of tissue pancreas tumor removed. (D) MRI scan of the pituitary gland. (E) Emission computed tomography (ECT) images on parathyroid glands showed one radioactive uptake. (F) Postoperative pathology showed nodular hyperplasia of the parathyroid gland.
Figure 2
Figure 2
Pedigree diagram of the proband’s family. Family members are indicated by generations (Roman numbers) and individuals (Arabic numbers). Circles indicated women and square indicated men. Clinical status was denoted: open symbols, normal; solid symbols affected.
Figure 3
Figure 3
(A, B) Dual-phase 99mTc-MIBI parathyroid scan on parathyroid glands with three focal uptakes. (C, D) Ultrasound scan of parathyroid glands. (E, F) Complete hyperechoic area in the parathyroid glands indicated a complete ablation. (G ,H) Postoperative contrast enhanced ultrasound for parathyroid glands did not show blood flow in the remaining lesions.
Figure 4
Figure 4
Serum PTH and calcium levels before and after ultrasound-guided MWA. MWA, microwave ablation.
See this image and copyright information in PMC

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