Abstract
Abstract
Introduction:
Parathyroid surgery has evolved considerably over the past decade. It is now often performed as an image-directed, focused exploration and accomplished on an outpatient basis. The mainstay of targeted surgery remains the intraoperative parathyroid hormone level assay (IOPTH), which helps guard against the double adenoma, as seen in this case.
Methods:
The patient is a 74-year-old female with mild hyperparathyroidism (HPT). This is the typical demographic for patients with primary HPT. Ultrasound imaging and a sestamibi scan suggested a left inferior parathyroid adenoma.
Results:
Biochemically and histologically confirmed double adenomas were removed (left inferior and overly descended left superior). This resulted in a reduction of the IOPTH from 186.6 to 27.8 at 10 minutes, indicating a surgical cure.
Conclusions:
Minimally invasive parathyroid surgery can be accomplished in the majority of patients with primary HPT. IOPTH is necessary if targeted surgery is contemplated to reveal the presence of a double adenoma and avoid the need for reoperative surgery.
Neither of the authors have any conflicts or dualities of interest to disclose that relate to this subject matter.
Runtime of video: 6 mins 20 secs
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