Open AccessPreventing blind thyroid lobectomy in patients with intrathyroidal hyperfunctioning parathyroid glands with radioguided enucleation
Author(s) -
Sophie Dream,
Brenessa Lindeman,
Herbert Chen
Publication year - 2020
Publication title -
international journal of endocrine oncology
Language(s) - English
Resource type - Journals
eISSN - 2045-0877
pISSN - 2045-0869
DOI - 10.2217/ije-2019-0013
Subject(s) - medicine , enucleation , thyroid , gamma probe , parathyroidectomy , parathyroid gland , hyperparathyroidism , primary hyperparathyroidism , parathyroid hormone , surgery , radiology , calcium , sentinel lymph node , cancer , breast cancer
Aim: Hyperfunctioning intrathyroidal parathyroid glands are rare and often result in thyroid lobectomy. This study examines the utility of radioguided surgery to guide enucleation of intrathyroidal parathyroids. Methods: Between December 2002 and March 2018, 2291 patients underwent parathyroidectomy by one surgeon for primary hyperparathyroidism. A total of 74 (3%) patients had an ectopic intrathyroidal parathyroid gland and underwent radioguided. Results: All of intrathyroidal parathyroid glands were localized with the gamma probe. In vivo radionuclide counts were above 120% of the background in all but three patients. All intrathyroidal parathyroids were enucleated with the guidance of the gamma probe. Conclusion: Radioguided surgery is useful for intraoperative identification of hyperfunctioning, intrathyroidal parathyroid glands. This technique allows for enucleation of the abnormal parathyroid gland, avoiding thyroid lobectomy and preserving healthy thyroid parenchyma.