PMID- 22735224
OWN - NLM
STAT- MEDLINE
DCOM- 20130329
LR  - 20180202
IS  - 1806-9282 (Electronic)
IS  - 0104-4230 (Linking)
VI  - 58
IP  - 3
DP  - 2012 May-Jun
TI  - Supernumerary parathyroid glands in hyperparathyroidism associated with multiple 
      endocrine neoplasia type 1.
PG  - 323-7
LID - S0104-42302012000300012 [pii]
AB  - OBJECTIVE: To evaluate frequency, anatomic presentation, and quantities of 
      supernumerary parathyroids glands in patients with primary hyperparathyroidism 
      (HPT1) associated with multiple endocrine neoplasia type 1 (MEN1), as well as the 
      importance of thymectomy, and the benefits of localizing examinations for those 
      glands. METHODS: Forty-one patients with hyperparathyroidism associated with MEN1 
      who underwent parathyroidectomy between 1997 and 2007 were retrospectively 
      studied. The location and number of supernumerary parathyroids were reviewed, as 
      well as whether cervical ultrasound and parathyroid SESTAMIBI scan (MIBI) were 
      useful diagnostic tools. RESULTS: In five patients (12.2%) a supernumerary gland 
      was identified. In three of these cases (40%), the glands were near the thyroid 
      gland and were found during the procedure. None of the imaging examinations were 
      able to detect supernumerary parathyroids. In one case, only the pathologic 
      examination could find a microscopic fifth gland in the thymus. In the last case, 
      the supernumerary gland was resected through a sternotomy after a recurrence of 
      hyperparathyroidism, ten years after the initial four-gland parathyroidectomy 
      without thymectomy. MIBI was capable of detecting this gland, but only in the 
      recurrent setting. Cervical ultrasound did not detect any supernumerary glands. 
      CONCLUSION: The frequency of supernumerary parathyroid gland in the HPT1/MEN1 
      patients studied (12.2%) was significant. Surgeons should be aware of the need to 
      search for supernumerary glands during neck exploration, besides the thymus. 
      Imaging examinations were not useful in the pre-surgical location of these 
      glands, and one case presented a recurrence of hyperparathyroidism.
FAU - d'Alessandro, Andre Fernandes
AU  - d'Alessandro AF
AD  - Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao 
      Paulo, SP, Brazil.
FAU - Montenegro, Fabio Luiz de Menezes
AU  - Montenegro FL
FAU - Brandao, Lenine Garcia
AU  - Brandao LG
FAU - Lourenco, Delmar Muniz Jr
AU  - Lourenco DM Jr
FAU - Toledo, Sergio de Almeida
AU  - Toledo Sde A
FAU - Cordeiro, Anoi Castro
AU  - Cordeiro AC
LA  - eng
PT  - Journal Article
PL  - Brazil
TA  - Rev Assoc Med Bras (1992)
JT  - Revista da Associacao Medica Brasileira (1992)
JID - 9308586
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism/etiology/*pathology
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/complications/*pathology
MH  - Parathyroid Glands/*abnormalities/pathology/surgery
MH  - Retrospective Studies
MH  - Thymectomy
MH  - Young Adult
EDAT- 2012/06/28 06:00
MHDA- 2013/03/30 06:00
CRDT- 2012/06/28 06:00
PHST- 2011/04/27 00:00 [received]
PHST- 2012/02/10 00:00 [accepted]
PHST- 2012/06/28 06:00 [entrez]
PHST- 2012/06/28 06:00 [pubmed]
PHST- 2013/03/30 06:00 [medline]
AID - S0104-42302012000300012 [pii]
PST - ppublish
SO  - Rev Assoc Med Bras (1992). 2012 May-Jun;58(3):323-7.