We report the case of a 54-year-old woman undergoing radioguided parathyroidectomy in whom four normal glands were identified on cervical exploration. The gamma probe was instrumental in guiding us to the adenoma in a fifth gland that was not visible and was localized to the parenchyma of the left lobe of the thyroid gland. Many surgeons do not advocate use of the gamma probe in minimally invasive parathyroidectomy and rely solely on focused exploration on the basis of a preoperative sestamibi scan and intraoperative rapid parathyroid hormone assays. This case, however, illustrates the utility of the gamma probe in parathyroid adenoma localization.
Get full access to this article
View all access options for this article.
References
1.
AdamiS., MarcocciC., GattiD.Epidemiology of primary hyperparathyroidism in Europe.J Bone Miner Res2002; 17(Suppl 2): N18–23.
2.
MandlF.Therapeutischer Versuch bei Ostitis fibrosa generalisata mittels Exstirpation eines Epithelkörperchentumors.Wien Klin Wochenschr1925; 38: 1343–4.
3.
van HeerdenJ.A., GrantC.S.Surgical treatment of primary hyperparathyroidism: an institutional perspective.World J Surg1991; 15: 688–92.
NormanJ., DenhamD.Minimally invasive radioguided parathyroidectomy in the reoperative neck.Surgery1998; 124: 1088–92.
6.
MurphyC., NormanJ.The 20% rule: a simple, instantaneous radioactivity measurement defines cure and allows elimination of frozen sections and hormone assays during parathyroidectomy.Surgery1999; 126: 1023–8.
7.
NormanJ.G., JaffrayC.E., ChhedaH.The false-positive parathyroid sestamibi: a real or perceived problem and a case for radioguided parathyroidectomy.Ann Surg2000; 231: 31–7.
8.
BurkeyS.H., SnyderW.H.III, NwariakuF., WatumullL.Directed parathyroidectomy: feasibility and performance in 100 consecutive patients with primary hyperparathyroidism.Arch Surg2003; 138: 604–8.
