Preoperative localization of enlarged parathyroid glands

Nine patients suspected of having parathyroid adenoma or hyperplasia on the basis of laboratory tests were examined by semiselective venous sampling for parathyroid hormone after unsuccessful neck explorations. Two pathologic parathyroid glands were found at re-operation. Only one was suspected preoperatively on the basis of venous sampling. Twenty patients suspected of having parathyroid adenoma or hyperplasia on the basis of the laboratory tests were examined by real-time sonography. Twelve adenomas and ten hyperplastic glands were found at operation. All the adenomas and hyperplastic parathyroid glands were preoperatively discovered with ultrasonography, but there were also three false-positive findings.