Open AccessRadio-guided parathyroidectomy for recurrent renal hyperparathyroidism caused by graft hyperplasia
Author(s) -
Zoran Lončar,
K Tausanovic,
N. Kozarevic,
Vlada Živaljević,
Branislav Oluić,
Ivan Paunović
Publication year - 2014
Publication title -
acta chirurgica iugoslavica
Language(s) - English
Resource type - Journals
eISSN - 2406-0887
pISSN - 0354-950X
DOI - 10.2298/aci1403073l
Subject(s) - medicine , hyperparathyroidism , parathyroidectomy , secondary hyperparathyroidism , sternocleidomastoid muscle , hyperplasia , autotransplantation , surgery , forearm , scintigraphy , urology , radiology , transplantation , parathyroid hormone , pathology , calcium
Radio-guided surgery offers several advantages in treatment of primary hyperparathyroidism. It is considered less helpful in renal hyperparathyroidism, but it could be of great advantage in the treatment of persistent or recurrent secondary hyperparathyroidism. One of the surgical options for symptomatic renal hyperparathyroidism is total parathyroidectomy with autotransplantation of hyperplastic parathyroid tissue in forearm muscles or sternocleidomastoid muscle. Recurrence can occur and is most likely caused by graft hyperplasia. In this report we present the case of 54-year-old woman with recurrent renal hyperparathyroidism caused by hyperplasia of the graft in sternocleidomastoid muscle. Unfortunately no sutures or clips were placed at initial surgery to identify the location of the parathyroid tissue. The preoperative assessment consisting of 99mTc-sestamibi scintigraphy identified a parathyroid tissue in the in the middle third of sternocleidomastoid muscle. The patient underwent a radio-guided neck re-exploration that allowed a rapid localization and excision of the hyperplastic graft.