RETROSPECTIVE EVALUATION OF 53 CASES OF PRIMARY HYPER-PARATHYROIDISM

Recently the measurement of calcium level in blood has become easy, and resultantly the rate of occurrence of primary hyperparathyroidism has been increasing. We have retrospectively evaluated 53 cases of primary hyperparathyroidism in term of preoperative diagnosis. Hypercalcemia was recognized in all cases and hypophosphatemia in 36 cases (67.9%). The sensitivities of intact PTH, C-PTH and HS-PTH were 95.3%, 38.9% and 95.2%, respectively. The mean size of the resected tumors was 2.3±1.1cm in diameter, and the mean weight was 1, 241±2, 061mg. There was a signigicant correlation between the value of intact PTH and the mean weight and there were significant correlations between the value of HS-PTH and the both mean size and weight. Clinically. 35.8% of patients had no specific signs or symptoms (chemical type). 47.2% had a renal stone and 17.0% showed bone change. The histological types of recected parathyroid tumors were adenoma in 92.5% of the patients, hyperplasia in 7.5% and no carcinomas. In 49 adenoma cases, the sensitivities of ultrasonogram, CT, Tl-Tc scitigram, Tc-MIBI and MRI were 85.7%, 77.5%, 81.8%. 95.2% (100% in ectopic adenoma) and 58.3%, respectively. Tc-MIBI was the most reliable method. Ectokic adenomas were recognized in 16.7%, and 87.5% of these ectopic adenomas were detected in the thymus. It appears efficacious to start at the thymus for exploration of ectopic adenoma.