PARATHYROID ADENOMAS: A SINGLE CENTER'S EXPERIENCE WITH 36 CASES

Abstract

36 patients with parathyroid adenoma were encountered at the General Surgery Department of Ege University Medical Faculty between January 1980 and June 1995. Primary hyperparathyroidism was detected preoperatively in 24 patients, and in others the diagnosis was done peroperatively. Patients with hyperparathyroidism are associated with enlargement of a single gland, high serum calcium, alkaline phosphatase (ALP) and parathormon levels, and normal or decreased serum phosphorus levels. Twenty-nine patients (81%) had adenomas at the inferior pole of thyroid gland. Bilateral neck exploration was preferred in all patients. The most leading diagnostic methods were neck ultrasonography (11 patients 31%) and Thallium-Technetium subtraction scintigraphy (11 patients 31%). There wasn't any mortality but 23 patients revealed severe and/or moderate hypocalcemic symptoms in the postoperative period.

In conclusion, both inferior and superior thyroid lobe should be explored bilaterally in suspicious cases. Gravity may be responsible for inferior location. Since about one third of patients were asymptomatic and incidence of dual adenoma is 2-5%, bilateral neck exploration should be preferred in all thyroid and parathyroid operations.