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The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism Powell AC; Alexander HR; Pingpank JF; Steinberg SM; Skarulis M; Bartlett DL; Agarwal S; Cochran C; Seidel G; Fraker D; Hughes MS; Jensen RT; Marx SJ; Libutti SKSurgery 2008[Dec]; 144 (6): 878-83; discussion 883-4BACKGROUND: 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.|Adult[MESH]|Female[MESH]|Humans[MESH]|Hyperparathyroidism/etiology/*surgery[MESH]|Male[MESH]|Multiple Endocrine Neoplasia Type 1/*complications[MESH]|Neck[MESH]|Thymectomy/*methods[MESH] |
