Negative preoperative localization studies are highly predictive of multiglandular disease in sporadic primary hyperparathyroidism☆
Section snippets
Patients and methods
From 1999 to 2001, 213 patients were eligible for a video-assisted approach and underwent preoperative localization studies that included sestamibi scanning and ultrasonography. The study result was considered to be positive when it showed an image that was considered compatible with a parathyroid adenoma. The study result was considered to be negative when it did not identify any image that was compatible with a parathyroid adenoma. The preoperative studies were performed blinded from the
Demographics and preoperative tests
From 1999 to 2001, 172 women and 41 men underwent surgery for SPHPT in our department and were included in this retrospective investigation. The mean age was 59.5±14.7 years (range, 16-89 years). The mean preoperative calcium level was 2.86±0.25 mmol/L (range, 2.4-4.03 mmol/L). The mean preoperative parathyroid hormone level was 158±113 pg/mL (range, 44-725 pg/mL).
We observed no difference in terms of sex or age between the groups of patients with negative or positive preoperative localization
Discussion
The results of localization studies in our study are comparable to those reported in other studies.7 Sestamibi scanning is the most reliable preoperative localization test in our department; the sensitivity of ultrasonography is only 48%. However, most patients who were referred to our department had already had this investigation performed elsewhere. As in other reports, localization studies are less efficient in the presence of multiglandular disease.
The high rate of cured patients could be
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Cited by (0)
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Presented at the 24th Annual Meeting of the American Association of Endocrine Surgeons, San Diego, California, May 11-14, 2003.