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2015 ; 4
(4
): 295-300
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Undescended parathyroid adenomas as cause of persistent hyperparathyroidism
#MMPMID26312215
Rioja P
; Mateu G
; Lorente-Poch L
; Sancho JJ
; Sitges-Serra A
Gland Surg
2015[Aug]; 4
(4
): 295-300
PMID26312215
show ga
BACKGROUND: Undescended glands are a rare cause of primary and secondary
hyperparathyroidism (HPT), but they are more common, however, among patients with
recurrent HPT or those who have undergone a failed initial cervical exploration.
The currently development of more precise noninvasive imaging techniques has
improved the results of preoperative diagnosis of these ectopic lesions. METHODS:
The operative reports of patients undergoing parathyroidectomy at our institution
were reviewed to identify patients with an undescended parathyroid gland
adenomas. Demographic, clinical, imaging and surgical variables were recorded.
RESULTS: Three patients were included: 2/598 parathyroidectomies performed for
primary HPT and 1/93 performed for secondary HPT. One case is presented as jaw
tumor syndrome (JTS). All the patients had undergone at least one operation
before the definitive focused surgery and represented 6% of our parathyroid
reoperations. No significant complications and no recurrences were observed in
the long-term follow up. CONCLUSIONS: Accurate preoperative localization of these
lesions was possible with noninvasive studies. High cure rate is possible through
selective approach when accurate preoperative localization. Thorough knowledge of
parathyroid embryology and meticulous surgical technique are essential,
particularly in patients with previous unsuccessful explorations.