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Radio‐guided surgery in recurrent renal hyperparathyroidism: Report of a case
Author(s) -
Navarra Giuseppe,
Ascanelli Simona,
Feggi Luciano,
Carcoforo Paolo,
Turini Alessandro
Publication year - 2000
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/1097-0347(200009)22:6<618::aid-hed11>3.0.co;2-g
Subject(s) - medicine , mediastinum , secondary hyperparathyroidism , hyperparathyroidism , radiology , surgery , parathyroid hormone , magnetic resonance imaging , scintigraphy , primary hyperparathyroidism , calcium
Abstract Background It has been demonstrated that radio‐guided surgery offers several advantages in treating primary hyperparathyroidism. Even if it is considered less helpful in renal hyperparathyroidism, it could be of tremendous advantage in the treatment of persistent or recurrent secondary hyperparathyroidism. Methods We report a case of recurrent secondary hyperparathyroidism treated by the use of radio‐guided surgery. The preoperative assessment consisting of ultrasonography, magnetic resonance imaging, and 99mTc‐sestamibi scintigraphy identified a parathyroid in the upper mediastinum. The patient underwent a radio‐guided neck re‐exploration that allowed a rapid localization and excision of the ectopic gland, which was located in the anterosuperior mediastinum, in front of the trachea, between the innominant and the left common carotid artery. Results The operative time was 45 minutes. The patient was discharged on the first postoperative day. A decrease in serum calcium and parathyroid hormone was observed subsequently. A follow‐up of 6 months did not show any recurrence. Conclusions The case reported indicates that radio‐guided surgery can help surgeons detect parathyroid tissue in selected cases of renal hyperparathyroidism. © 2000 John Wiley & Sons, Inc. Head Neck 22: 618–620, 2000.