Related Experiment Video
Updated: Jul 2, 2025
Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two
Tim N Beck1, Gustavo Romero-Velez1, Salem I Noureldine2
1Department of Endocrine Surgery, Endocrinology and Metabolism Institute, Cleveland Clinic, OH, USA.
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.
