Ultrasound-guided microwave ablation for primary hyperparathyroidism in an elderly patient with pancytopenia: A case...

Primary hyperparathyroidism (PHPT) is the third major endocrine disorder characterized by increased secretion of parathyroid hormone, with an incidence of up to 3% in elderly women. Although current guidelines consider parathyroidectomy to be the only definitive treatment, it is extremely risky for elderly women with numerous underlying conditions. However, hypercalcemia and other clinical symptoms caused by PHPT can seriously threaten the health and quality of life of patients. Therefore, it is very important to find a safe and effective minimally invasive alternative therapy. Hence, we report a case of ultrasound-guided microwave ablation (MWA) for PHPT in an elderly patient with pancytopenia.

A 75-year-old female patient with pancytopenia was diagnosed with PHPT and was admitted for treatment due to her strong desire for treatment.

Imaging examination, laboratory examination and ultrasound-guided fine-needle aspiration cytology all led to a diagnosis of PHPT for the patient.

Considering the advanced age of the patient, suffering from pancytopenia and other underlying disease, the surgical risk is high, so MWA was selected for this hospitalization.

We found that after 6 months of treatment, the following 4 indicators of the patient returned to normal (parathyroid hormone, 66.9 pg/mL; ionic calcium, 1.19 mmol/L; serum total calcium, 2.28 mmol/L; phosphorus, 0.80 mmol/L). The lesion volume of the patient gradually decreased, and the reduction rate of lesion volume reached 70.3% by 6 months after ablation. There were no complications, and no parathyroid nodules regenerated during follow-up.

Ultrasound-guided MWA represents a safe and effective therapeutic option for elderly patients with PHPT.