Primary hyperparathyroidism is a common endocrinopathy. Multiple Endocrine Neoplasia Type 1 (MEN1) is a rare autosomal dominantly inherited endocrine tumor predisposition syndrome, with one of main manifestations being primary hyperparathyroidism. We retrospectively evaluated a set of 1011 patients who underwent surgery for primary hyperparathyroidism between the years 2018-2022, and found 78 (8 %) patients who underwent reoperations and 27 patients with MEN1 syndrome. In the group of patients with MEN1 syndrome, 7 (35 %) needed reoperations. Patients with multiple endocrine neoplasia syndrome have a higher risk of needing reoperation. Genetic testing can help identify MEN1 syndrome preoperatively and to better evaluate the approach to surgery.
- MeSH
- Humans MeSH
- Multiple Endocrine Neoplasia Type 1 * complications diagnosis genetics MeSH
- Hyperparathyroidism, Primary * diagnosis genetics surgery MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Úvod: Onemocnění příštítné a štítné žlázy jsou jedna z nejčastějších endokrinních onemocnění, ale souběžné chirurgické řešení obou endokrinních systémů je stále předmětem diskuze. Metody: Retrospektivně jsme vyhodnotili 1574 pacientů operovaných pro primární hyperparatyreózu na III. chirurgické klinice 1. LF UK a FN Motol Praha, kteří měli popsán ultrazvuk štítné žlázy a příštítných tělísek. Pacienti byli rozděleni do dvou skupin – bez operace štítné žlázy a s operací štítné žlázy. Výsledky: U 34 % pacientů s primární hyperparatyreózou byl proveden zákrok na štítné žláze. Ve skupině 2, kde byl proveden zákrok na štítné žláze, byl vyšší podíl popsaných abnormálních sonografických nálezů na štítné žláze (74 %), větší podíl bilaterální explorace krku (69 %) a delší doba hospitalizace (3,3 dne). Závěr: Pacient indikovaný k operaci pro onemocnění příštítných tělísek by měl být indikován i pro případný výkon na štítné žláze.
Introduction: Parathyroid and thyroid diseases are ones of the most common endocrine diseases, but simultaneous surgical treatment of both endocrine systems is still under discussion. Methods: We retrospectively evaluated 1,574 patients operated for primary hyperparathyroidism at the 3rd Department of Surgery, 1st Faculty Medicine, Charles University and University Hospital Motol in Prague with the thyroid and parathyroid ultrasound reports available. The patients were divided into two groups – with and without thyroid surgery. Results: Thyroid surgery was performed in 34% of patients with primary hyperparathyroidism. Group 2, where thyroid surgery was performed, showed a higher proportion of reported abnormal thyroid sonographic findings (74%), a higher proportion of bilateral throat exploration (69%) and a longer hospital stay (3.3 days). Conclusion: A patient indicated for surgery for parathyroid disease should also be indicated for possible thyroid surgery.
V kazuistice popisujeme neobvyklý případ rezistence na krku, jehož příčinou bylo zakrvácení do adenomu příštítného tělíska. 72letá pacientka byla vyšetřena pro rezistenci na krku, v diferenciální diagnostice bylo uvažováno o nádoru štítné žlázy. Zároveň byla u pacientky biochemicky diagnostikována primární hyperparatyreóza. Při operaci byl z krční incize odstraněn tuhý uzel odpovídající hemoragicky změněnému adenomu příštítného tělíska. Ačkoliv příčinou tuhé rezistence na krku je zřídka adenom příštítného tělíska, měl by na ni endokrinolog či chirurg pomýšlet.
The case report describes an unusual case of the resistance of the neck caused by bleeding into the parathyroid adenoma. A 72-year-old female patient was examined for resistance of the neck, differential diagnosis was a thyroid tumor. At the same time, primary hyperparathyroidism was confirmed by the patient. During surgery, a rigid node corresponding to the haemorrhagically altered parathyroid adenoma was removed from the cervical incision. Although the cause of the resistance of the neck is rarely the parathyroid adenoma, the endocrinologist or surgeon should think of it.
- MeSH
- Adenoma surgery diagnosis complications MeSH
- Hypercalcemia etiology MeSH
- Hemorrhage etiology MeSH
- Humans MeSH
- Parathyroid Neoplasms * surgery diagnosis complications MeSH
- Hyperparathyroidism, Primary diagnosis complications MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
BACKGROUND/AIM: Parathyroid carcinoma is a rare clinical entity, which represents one of the main reasons, why surgery should be performed in specialized centres. Preoperatively, it is very difficult to distinguish between benign and malignant hyperparathyroidism. PATIENTS AND METHODS: During the years 1996-2016, we performed 2,220 operations in 2,075 patients with a diagnosis of primary hyperparathyroidism. RESULTS: Among these 2,220 operations, there were 16 operations for parathyroid carcinoma. These 16 operations, including reoperations, were performed in four patients. Two patients had no reoperation, but another 2 patients required 14 reoperations in total. Parathyroid carcinoma was described in 0.2% of all patients with a diagnosis of primary hyperparathyroidism. The number of operations was 0.73% of all operations of primary hyperparathyroidism in years 1996-2016. CONCLUSION: Prognosis of parathyroid carcinoma is quite favourable, patients evidence a long-term survival rate after the primary operation. However, every reoperation increases the number of possible complications, including recurrent laryngeal nerve injury.
- MeSH
- Biomarkers MeSH
- Middle Aged MeSH
- Humans MeSH
- Multimodal Imaging MeSH
- Parathyroid Neoplasms complications diagnosis epidemiology surgery MeSH
- Parathyroidectomy MeSH
- Postoperative Complications MeSH
- Hyperparathyroidism, Primary diagnosis epidemiology etiology surgery MeSH
- Aged MeSH
- Symptom Assessment MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Keywords
- iPHT,
- MeSH
- Biomarkers MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Parathyroid Hormone * blood MeSH
- Parathyroidectomy * methods MeSH
- Monitoring, Intraoperative MeSH
- Postoperative Period MeSH
- Preoperative Period MeSH
- Hyperparathyroidism, Primary * diagnosis etiology surgery pathology MeSH
- Prospective Studies MeSH
- Aged MeSH
- Calcium blood MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
