25 February 2003
Radioguided parathyroidectomy for renal hyperparathyroidism.Wataru Kitagawa, Kazuo Shimizu, Haruki Akasu, Shigeo Tanaka
Med Sci Monit 2003; 9(2): CS9-12 :: ID: 4750
BACKGROUND: The usefulness of radioguided parathyroidectomy for primary hyperparathyroidism has been demonstrated in recent years, however, its applicability to renal hyperparathyroidism is uncertain. We report a case in which radioguided parathyroidectomy was used to treat renal hyperparathyroidism and was found to be helpful in preventing persistent and recurrent hyperparathyroidism. CASE REPORT: The patient was a 55-year-old Japanese woman who had received hemodialysis for 67 months. Three enlarged parathyroid glands were identified preoperatively by ultrasonography. Two hours before the operation, the patient received an intravenous injection of 600 MBq 99mTc-sestamibi and radioguided parathyroidectomy was performed. The three enlarged parathyroid glands were resected easily by the use of radioguided surgery. However, the localization of the residual parathyroid gland was uncertain. The operative field was analyzed using an intraoperative gamma probe, and the upper mediastinum was found to have higher radioactivity than the other regions. The upper mediastinum was dissected and the enlarged parathyroid gland was identified in the anterosuperior mediastinum in front of the trachea. The target parathyroid gland was then removed. The pathological diagnosis was hyperplasia of the parathyroid. No complications were observed and a follow-up examination 30 months later did not show any recurrence. CONCLUSIONS: An intraoperative gamma probe can be used to locate supernumerary and ectopic parathyroid glands. Radioguided parathyroidectomy for renal hyperparathyroidism can theoretically decrease the risk of persistent and recurrent hyperparathyroidism that is due to remaining parathyroid tissue.
Keywords: Hyperparathyroidism, Secondary - surgery, Kidney Diseases - complications, Parathyroid Glands - pathology, Parathyroid Glands - surgery, Parathyroid Neoplasms - pathology, Parathyroid Neoplasms - radiography, Parathyroid Neoplasms - surgery, Radiopharmaceuticals - diagnostic use, Technetium Tc 99m Sestamibi - diagnostic use
01 May 2023 : EditorialEditorial: Twenty Years On from Sequencing the Human Genome, Personalized/Precision Oncology Prepares to Meet the Challenges of Checkpoint Inhibitor Therapy
Med Sci Monit 2023; 29:e940911
28 May 2023 : Database AnalysisScientometric and Visualized Analysis of Intravoxel Incoherent Motion Magnetic Resonance Imaging: 1988-2021
Med Sci Monit In Press; DOI: 10.12659/MSM.938715
25 May 2023 : Database AnalysisThe COVID-19 Crisis and the Incidence of Alcohol-Related Deaths in Poland
Med Sci Monit In Press; DOI: 10.12659/MSM.940904
25 May 2023 : Review articleA Review of Preclinical and Clinical Studies in Support of the Role of Non-Steroidal Anti-Inflammatory Drug...
Med Sci Monit In Press; DOI: 10.12659/MSM.940635
25 May 2023 : Clinical ResearchPeriapical Lesions and Missed Canals in Endodontically Treated Teeth: A Cone-Beam Computed Tomographic Stud...
Med Sci Monit In Press; DOI: 10.12659/MSM.940533
Most Viewed Current Articles
13 Nov 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : EditorialEditorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...
Med Sci Monit 2022; 28:e935952