American Association of Endocrine SurgeonUse of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization
Section snippets
Methods
Patients presenting for surgical evaluation of hyperparathyroidism were initially evaluated with a full history, physical examination, and review of the relevant laboratory studies. In patients who had had prior neck surgery, operative notes and pathology reports were reviewed whenever possible. The diagnosis of HPT was established by calcium and parathyroid hormone levels. Patients were considered to have HPT if their calcium and PTH levels were above normal, or if their calcium level was in
Results
From 2000 – present, 908 patients underwent parathyroidectomy at our institution. Of these, 54 (6%) patients underwent 57 ultrasound guided parathyroid biopsies. There were 3 patients who underwent FNA of 2 separate areas identified on ultrasound as suspected parathyroid lesions. The average age was 55 ± 13 years (range 25-77) and there were 39 females and 15 males. There were 49 patients with 10 HPT, and 5 with a history of renal failure resulting in tertiary HPT. Two of the 49 patients with 10
Discussion
An increasing number of endocrine surgeons are using ultrasound as an imaging modality in the office and operating room in the evaluation of patients with HPT.12 The performance of ultrasound by the surgeon may be particularly relevant in patients presenting for re-operative parathyroid surgery, where knowledge of the location of prior parathyroid resections from operative notes and pathology reports is essential in interpreting ultrasound findings. In addition, real-time examination of the
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