Abstract:Objective:To explore the diagnosis and surgical treatment of primary parathyroid tumor (PTT).
Methods :The clinical data of 12 patients with primary parathyroid tumor and treated by operation were analyzed retrospectively.In this group, 1 patient with parathyroid carcinoma complicated with goiter and was diagnosed as MEN-Ⅰ; 1 case with parathyroid cyst;10 cases with parathyroid adenoma (PTA), one of which was complicated with goiter, and one MEN-1 case with bilateral parathyroid adenoma, and 1 was ectopic PTA.
Results:The diagnosis were made before operation based on the result of blood calcium and phosphorous, B-type ultrasound, CT and 99mTc-MIBI in 10 cases. Unilateral neck exploration (UNE) was performed in 8 cases with parathyroid adenoma and in 1 case with parathyroid cyst; the case of parathyroid carcinoma with MEN-1 and the MEN-1 case of parathyroid adenoma with goiter had bilateral neck exploration (BNE) and the case with parathyroid carcinoma underwent radical operation. All of the cases were followed up for average 38 months. In the followup time, the level of serum calcium was normal in 11 cases and 8 patients were asymptomatic; only 1 case with parathyroid adenoma who underwent UNE developed parathyroid hyperplasia in the opposite side, and was cured by re-operation.
Conclusions:UNE for single parathyroid adenoma or cyst is feasible, if accurate image localizations is available; the cases with parathyroid carcinoma or parathyroid adenoma with goiter or MEN-Ⅰshould undergo BNE. By close follow up of the cases, the effect of surgical treatment can be determined, and also has the advantage of early find of cases with recurrence or with MEN-1.