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Multiglandular Parathyroid Disease

Introduction: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8–33% of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical t...

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Autores principales: Kowalski, Grzegorz, Buła, Grzegorz, Bednarczyk, Adam, Gawrychowska, Agata, Gawrychowski, Jacek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410354/
https://www.ncbi.nlm.nih.gov/pubmed/36013465
http://dx.doi.org/10.3390/life12081286
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author Kowalski, Grzegorz
Buła, Grzegorz
Bednarczyk, Adam
Gawrychowska, Agata
Gawrychowski, Jacek
author_facet Kowalski, Grzegorz
Buła, Grzegorz
Bednarczyk, Adam
Gawrychowska, Agata
Gawrychowski, Jacek
author_sort Kowalski, Grzegorz
collection PubMed
description Introduction: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8–33% of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical treatment failures. Methods: We performed a retrospective study of 163 patients with pHPT undergoing parathyroidectomy (PTX) at the Department of General and Endocrine Surgery between 1983 and 2018. All these patients were diagnosed with MGD. This group of patients was compared with a group of 856 patients with solitary disease operated for pHPT in the same period. Results: Among 163 patients—127 (79%) of them had two lesions, 28 (16%) had three, and 8 (5%) four. They were prevalently women over the age of 50. The diagnosis was based on PTH and ionized calcium studies and used sestamibi technetium-99m scintigraphy (MIBI) as well for us. Treatment was surgical. Conclusions: Parathyroidectomy (PTX) for multiglandular parathyroid disease (MGD) is associated with a higher operative risk of failure compared to solitary disease. Preoperative diagnosis and localization of the parathyroid glands is an extremely important element of treatment. Diagnosis is based on PTH and calcium levels. Ultrasonography (USG), MRI, and scintigraphy are very helpful in diagnosis. Mediastinal multiglandular parathyroid disease (MGD) is associated with increased surgical treatment failures. The treatment is surgical and consists of the removal of the masses or complete parathyroidectomy. Based on this study, we support the existence of multiple adenomas and advocate the removal of only macroscopically enlarged parathyroid glands in patients with primary hyperparathyroidism.
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spelling pubmed-94103542022-08-26 Multiglandular Parathyroid Disease Kowalski, Grzegorz Buła, Grzegorz Bednarczyk, Adam Gawrychowska, Agata Gawrychowski, Jacek Life (Basel) Article Introduction: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8–33% of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical treatment failures. Methods: We performed a retrospective study of 163 patients with pHPT undergoing parathyroidectomy (PTX) at the Department of General and Endocrine Surgery between 1983 and 2018. All these patients were diagnosed with MGD. This group of patients was compared with a group of 856 patients with solitary disease operated for pHPT in the same period. Results: Among 163 patients—127 (79%) of them had two lesions, 28 (16%) had three, and 8 (5%) four. They were prevalently women over the age of 50. The diagnosis was based on PTH and ionized calcium studies and used sestamibi technetium-99m scintigraphy (MIBI) as well for us. Treatment was surgical. Conclusions: Parathyroidectomy (PTX) for multiglandular parathyroid disease (MGD) is associated with a higher operative risk of failure compared to solitary disease. Preoperative diagnosis and localization of the parathyroid glands is an extremely important element of treatment. Diagnosis is based on PTH and calcium levels. Ultrasonography (USG), MRI, and scintigraphy are very helpful in diagnosis. Mediastinal multiglandular parathyroid disease (MGD) is associated with increased surgical treatment failures. The treatment is surgical and consists of the removal of the masses or complete parathyroidectomy. Based on this study, we support the existence of multiple adenomas and advocate the removal of only macroscopically enlarged parathyroid glands in patients with primary hyperparathyroidism. MDPI 2022-08-22 /pmc/articles/PMC9410354/ /pubmed/36013465 http://dx.doi.org/10.3390/life12081286 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kowalski, Grzegorz
Buła, Grzegorz
Bednarczyk, Adam
Gawrychowska, Agata
Gawrychowski, Jacek
Multiglandular Parathyroid Disease
title Multiglandular Parathyroid Disease
title_full Multiglandular Parathyroid Disease
title_fullStr Multiglandular Parathyroid Disease
title_full_unstemmed Multiglandular Parathyroid Disease
title_short Multiglandular Parathyroid Disease
title_sort multiglandular parathyroid disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410354/
https://www.ncbi.nlm.nih.gov/pubmed/36013465
http://dx.doi.org/10.3390/life12081286
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