Related Experiment Videos
[Hyperparathyroidism and intrathyroid parathyroid gland. 43 cases]
C Proye1, J P Bizard, B Carnaille
1Service de Chirurgie générale et Endocrinienne, CHU de Lille, Hôpital Claude-Huriez.
Annales De Chirurgie
|January 1, 1994
Summary
Intrathyroidal parathyroid glands occur in 3.6% of hyperparathyroidism surgeries. Preoperative detection is challenging, but ultrasonography may aid in identifying these glands during repeat procedures.
Area of Science:
- Endocrinology
- Surgical Pathology
Background:
- Intrathyroidal parathyroid glands are an uncommon finding in patients undergoing surgery for hyperparathyroidism (HPT).
- The reported incidence of intrathyroidal parathyroid glands varies significantly across existing literature.
Purpose of the Study:
- To determine the incidence of intrathyroidal parathyroid glands in a large cohort of patients surgically treated for HPT.
- To evaluate the detectability of these glands using various preoperative and intraoperative methods.
Main Methods:
- Retrospective analysis of 1200 consecutive HPT surgeries performed between December 1965 and July 1992.
- Histological confirmation of intrathyroidal parathyroid glands.
- Review of preoperative ultrasound findings and intraoperative palpation/visualization data.
Main Results:
- 43 patients (3.6%) had 47 histologically-proven intrathyroidal parathyroid glands (44 lower, 3 upper).
- Fifteen patients had concurrent thyroid abnormalities; 8 of 14 preoperative ultrasounds showed abnormalities.
- 34 glands were visible on the thyroid surface, 5 palpable, and 8 found in lobectomy specimens; no fail-proof preoperative detection method was identified.
Conclusions:
- Intrathyroidal parathyroid glands can be completely concealed within the thyroid, even without thyroid disease.
- Ectopic glands most commonly affect the lower parathyroid glands.
- Ultrasonography, particularly pre- or intra-operative, is recommended for detecting intrathyroidal glands in persistent HPT cases, especially during repeat surgeries.