Detection and management of parathyroid tumors

Current Opinion in Oncology

Volumn 9, Issue 1, 1997, Pages 75-78

  Hodin, Richard A ^a   Silen, William W ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AUTONOMIC NERVOUS SYSTEM; CELL GROWTH; GENE MUTATION; HUMAN; HYPERPARATHYROIDISM; PARATHYROID TUMOR; PRIORITY JOURNAL; PROTO ONCOGENE; REVIEW; SURGICAL TECHNIQUE; TREATMENT PLANNING; TUMOR SUPPRESSOR GENE;

EID: 0030944502     PISSN: 10408746     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001622-199701000-00012     Document Type: Review

References (24)

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6. Tezelman S, Shen W, Siperstein AE, Duh Q-Y, Clark OH: Persistent or recurrent hyperparathyroidism in patients with double adenomas. Surgery 1995, 118:1115-1124. This paper explores the question of whether double adenoma patients are clinically distinct from those with diffuse hyperplasia. Their data suggest that the two lesions are, indeed, different entities.
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9. Chan AK, Duh Q-Y, Katz MH, Siperstein AE, Clark OH: Clinical manifestations of primary hyperparathyroidism before and after parathyroidectomy: a case-control study. Ann Surg 1995, 222:402-414. This is a very carefully performed, retrospective study addressing the clinical manifestations of primary hyperparathyroidism. The authors demonstrated that many of the symptoms of hyperparathyroidism are subtle and are often not recognized preoperatively. The benefits of surgical intervention are clear and suggest that a more liberal approach to operation may be justified.
10. Kenny AM, MacGillivray DC, Pilbeam CC, Crombie HD, Raisz LG: Fracture incidence in postmenopausal women with primary hyperparathyroidism. Surgery 1995, 118:109-114. This paper indicates that primary hyperparathyroidism is associated with an increase in bony fractures in postmenopausal women, suggesting that early surgical intervention may be warranted.
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12. Hedback G, Oden A, Tisell L-E: Parathyroid adenoma weight and the risk of death after treatment for primary hyperparathyroidism. Surgery 1995, 117:134-139.
13. Bergenfelz A, Valdemarsson S, Tibblin S: Persistent elevated serum levels of intact parathyroid hormone after operation for sporadic parathyroid adenoma: evidence of detrimental effects of severe parathyroid disease. Surgery 1996, 119:624-633. In this study, increased serum parathyroid ism levels 8 weeks after surgery were found to predict a poor outcome, even after surgical cure. The authors proposed that earlier operative intervention may be warranted.
14. Chigot J-P, Menegaux F, Achrafi H: Should primary hyperparathyroidism be treated surgically in elderly patients older than 75 years? Surgery 1995, 117:397-401.
15. 99mTc sestamibi: a new agent for parathyroid imaging. Nucl Med Commun 1989, 10:791-794.
16. McHenry CR, Lee K, Saadey J, Neumann DR, Esselstyn CB Jr: Parathyroid localization with technetium-99m sestamibi: a prospective evaluation. J Am Coll Surg 1996, 183:25-30. This is a well done, propspective study on the value of sestamibi scans. The scans were found to be extremely accurate in those cases of single adenomas, but were insensitive in the setting of multiglandular disease.
17. Borley NR, Collins REC, O'Doherty M, Coakely A: Technetium-99m sestamibi parathyroid localization is accurate enough for scan-directed unilateral neck exploration. Br J Surg 1996, 83:989-991. This retrospective study confirms the findings of McHenry et al. (J Am Coll Surg 1996, 183:25-30) that setamibi scans are quite accurate in detecting single adenomas but are not useful in the setting of multiglandular disease.
18. Borley NR, Collins REC, O'Doherty M, Coakely A: Technetium-99m sestamibi parathyroid localization is accurate enough for scan-directed unilateral neck exploration. Br J Surg 1996, 83:989-991. This retrospective study confirms the findings of McHenry et al. (J Am Coll Surg 1996, 183:25-30) that setamibi scans are quite accurate in detecting single adenomas but are not useful in the setting of multiglandular disease.
19. Wei JP, Burko GJ: Analysis of savings in operative time for primary hyperparathyroidism using localization with technetium-99m sestamibi scan. Am J Surg 1995, 170:488-491. These authors carefully timed various portions of their neck explorations. They concluded that approximately 30 minutes of operative time could be saved by using preoperative sestamibi scans and unilateral explorations.
20. Zmora O, Schachter PP, Heyman Z, Shabtay M, Avigad I, Ayalon A: Correct preoperative localization: does it permit a change in operative strategy for primary hyperparathyroidism? Surgery 1995, 118:932-935. This paper is important in documenting the potential pitfall in unilateral neck explorations; 8.6% of their patients would have undergone failed operations.
21. Chryssochoos JT, Weber CJ, Cohen C, Moore J, DeRose PB, Hagler M, Bray R, Stempora L, Mainiero M, McGarity WC: DNA index and ploidy distinguish normal human parathyroids from parathyroid adenomas and primary hyperplastic parathyroids. Surgery 1995, 118:1041-1050. The DNA index was used to accurately differentiate normal from abnormal parathyroid glands. Although the clinical applicability of such a test remains limited, this paper may pave the way for future work addressing this important issue.
22. Harness JK, Organ CH, Thompson NW: Operative experience of U.S. general surgery residents in thyroid and parathyroid disease. Surgery 1995, 118:1063-1070. The data presented in this paper clearly indicates that many surgical trainees acquire only a limited experience in parathyorid operations.
23. Mowschenson PM, Hodin RA: Outpatient thyroid and parathyroid surgery: a prospective study of feasibility, safety, and costs. Surgery 1995, 118:1051-1054. As with many other operations that previously entailed postoperative stays in the hospital setting, endocrine surgery of the neck can also be safely performed on an out-patient basis.
24. Smythe WR, Bavaria JE, Hall RA, Kline GM, Kaiser LR: Thoracoscopic removal of mediastinal parathyroid adenoma. Ann Thorac Surg 1995, 59:236-238. Minimally invasive techniques continue to be applied in all areas of surgery.