Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades
Document Type
Journal Article
Publication Date
2-9-2024
Journal
American journal of surgery
DOI
10.1016/j.amjsurg.2024.02.008
Keywords
Bilateral exploration; Double adenoma; Multi-gland hyperplasia; Parathyroidectomy; Primary hyperparathyroidism
Abstract
BACKGROUND: We investigated if anatomic patterns of abnormal parathyroid glands have ch anged for primary hyperparathyroidism (pHPT) as atypical biochemical presentation (normohormonal and normocalcemic) has increased. METHODS: Retrospective review of patients with pHPT who underwent routine bilateral neck exploration. RESULTS: 2762 patients were included. The "late" cohort (2014-2020) exhibited lower preoperative calcium (10.8 vs 11.1 mg/dL; P = 0.001) and PTH levels (101 vs. 146 pg/mL; P = 0.001) compared to the "early" cohort (2000-2006). Patients with atypical biochemical profiles increased from 25.5% to 31.3% (P < 0.001). The prevalence of single adenoma (SA) decreased (66.1% vs 58.9%, P = 0.02) while the proportion of double adenoma (DA) increased (17.3% vs. 22.6%, P < 0.01). Upper parathyroid adenoma(s) remained the most common finding for SA and DA in both time points. CONCLUSIONS: Despite changes in patient characteristics, single upper adenoma and bilateral double upper adenomas remain the most common findings for patients with pHPT.
APA Citation
Beck, Tim N.; Romero-Velez, Gustavo; Noureldine, Salem I.; Plitt, Gilman; Wang, Sarah; and Jin, Judy, "Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades" (2024). GW Authored Works. Paper 4361.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4361
Department
Surgery
