Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five Patients
In primary hyperparathyroidism (PHPT) the diagnosis and treatment of ectopic parathyroid adenomas (EPTA) is a challenging process for head and neck surgeons. We present five patients with EPTA in different locations, along with an in-depth discussion of imaging modalities. We used sestamibi scintigr...
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| Format: | Article |
| Language: | English |
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Galenos Yayincilik
2020-06-01
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| Series: | Turkish Archives of Otorhinolaryngology |
| Subjects: | |
| Online Access: |
http://turkarchotolaryngol.net/archives/archive-detail/article-preview/challenges-in-the-management-of-ectopic-parathyroi/43043
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| _version_ | 1797920170947117056 |
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| author | Adem Binnetoğlu Berat Demir Javahir Mamadlı |
| author_facet | Adem Binnetoğlu Berat Demir Javahir Mamadlı |
| author_sort | Adem Binnetoğlu |
| collection | DOAJ |
| description | In primary hyperparathyroidism (PHPT) the diagnosis and treatment of ectopic parathyroid adenomas (EPTA) is a challenging process for head and neck surgeons. We present five patients with EPTA in different locations, along with an in-depth discussion of imaging modalities. We used sestamibi scintigraphy (MIBI) and ultrasound as first line imaging tools in asymptomatic hypercalcemia and PHPT. Single photon emission computed tomography (SPECT) was combined with MIBI or computed tomography (CT) if a parathyroid pathology was not localized initially. Four-dimensional parathyroid CT (4D-CT) was the last imaging modality preferred to localize the ectopic parathyroid gland. We performed focused unilateral neck exploration (FUNE) with intraoperative frozen section analysis as a routine procedure for imaging-detected lesions. Bilateral neck exploration was performed for re-exploration cases and imaging-negative cases. Histopathology confirmed EPTA and postoperative serum calcium normalized in all cases. 4D-CT is promising for ectopic parathyroid gland localization if all other imaging modalities fail. Despite the advancements in imaging, surgical experience continues to play the central role in the management of ectopic parathyroid pathologies. |
| first_indexed | 2024-04-10T13:57:07Z |
| format | Article |
| id | doaj.art-f6c797d6e7dc4f8aa2fe3d334b67cf26 |
| institution | Directory Open Access Journal |
| issn | 2667-7474 |
| language | English |
| last_indexed | 2024-04-10T13:57:07Z |
| publishDate | 2020-06-01 |
| publisher | Galenos Yayincilik |
| record_format | Article |
| series | Turkish Archives of Otorhinolaryngology |
| spelling | doaj.art-f6c797d6e7dc4f8aa2fe3d334b67cf262023-02-15T16:10:25ZengGalenos YayincilikTurkish Archives of Otorhinolaryngology2667-74742020-06-0158213313610.5152/tao.2020.478213049054Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five PatientsAdem Binnetoğlu0Berat Demir1Javahir Mamadlı2 Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey Department of Otorhinolaryngology-Head and Neck Surgery, Marmara University School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey In primary hyperparathyroidism (PHPT) the diagnosis and treatment of ectopic parathyroid adenomas (EPTA) is a challenging process for head and neck surgeons. We present five patients with EPTA in different locations, along with an in-depth discussion of imaging modalities. We used sestamibi scintigraphy (MIBI) and ultrasound as first line imaging tools in asymptomatic hypercalcemia and PHPT. Single photon emission computed tomography (SPECT) was combined with MIBI or computed tomography (CT) if a parathyroid pathology was not localized initially. Four-dimensional parathyroid CT (4D-CT) was the last imaging modality preferred to localize the ectopic parathyroid gland. We performed focused unilateral neck exploration (FUNE) with intraoperative frozen section analysis as a routine procedure for imaging-detected lesions. Bilateral neck exploration was performed for re-exploration cases and imaging-negative cases. Histopathology confirmed EPTA and postoperative serum calcium normalized in all cases. 4D-CT is promising for ectopic parathyroid gland localization if all other imaging modalities fail. Despite the advancements in imaging, surgical experience continues to play the central role in the management of ectopic parathyroid pathologies. http://turkarchotolaryngol.net/archives/archive-detail/article-preview/challenges-in-the-management-of-ectopic-parathyroi/43043 hyperparathyroidismparathyroid glandectopic parathyroid glandnuclear radiologyfour-dimensional computed tomographysurgery |
| spellingShingle | Adem Binnetoğlu Berat Demir Javahir Mamadlı Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five Patients Turkish Archives of Otorhinolaryngology hyperparathyroidism parathyroid gland ectopic parathyroid gland nuclear radiology four-dimensional computed tomography surgery |
| title | Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five Patients |
| title_full | Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five Patients |
| title_fullStr | Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five Patients |
| title_full_unstemmed | Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five Patients |
| title_short | Challenges in the Management of Ectopic Parathyroid Pathologies: A Case Series of Five Patients |
| title_sort | challenges in the management of ectopic parathyroid pathologies a case series of five patients |
| topic | hyperparathyroidism parathyroid gland ectopic parathyroid gland nuclear radiology four-dimensional computed tomography surgery |
| url |
http://turkarchotolaryngol.net/archives/archive-detail/article-preview/challenges-in-the-management-of-ectopic-parathyroi/43043
|
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