Radiologic Diagnosis and Surgical Treatment of Primary Hyperparathyroidism

With the advance in serum chemical analyses, the diagnosis of primary hyperparathyroidism has become more common, and patients without signs or symptoms attributable to the disease have increased. We performed this study to obtain further understanding and more supporting ideas for the diagnosis and treatment of primary hyperparathyroidism. Subjects and Method：A retrospective study of 19 patients with primary hyperparathyroidism who were treated by surgery from march 1999 to June 2005 was performed. Results：Preoperative localization was performed with computerized tomography, ultrasonography and 99mTc-sestamibi scan. A 99mTc-sestamibi scan has an accuracy of 84% and ultrasonography has an accuracy of 67% for parathyroid tumors. Combination of ultrasonography and 99mTc-sestamibi scan had the accuracy of 93%. All patients were treated by surgery. After surgery, serum calcium and intact parathyroid hormone levels returned rapidly to normal. Parathyroid carcinomas were firm in consistency and adhered to the surrounding tissue and thyroid gland. Conclusion：Ultrasonogram and 99mTc-sestamibi scan was effective for preoperative localization of tumor. If parathyroid carcinoma is suspected, the masswith potential local invasion or regional metastasis should be removed with en bloc resection.