PARATHYROID DOUBLE ADENOMAS - FACT OR FICTION

  • 1 January 1981
    • journal article
    • research article
    • Vol. 90  (3) , 523-526
Abstract
Primary hyperparathyroidism (HPT) may occasionally be caused by multiple adenomas. If this is true, then selective excision of the enlarged glands should be curative in such cases. To examine this proposition, the records of 1962 patients with surgically proven HPT were reviewed. Those with a history of identification and excision of 2 enlarged and histologically hypercellular parathyroid glands, each weighing > 70 mg, and identification and preservation of 2 other normal-sized parathyroid glands were called. There were 38 patients (1.9% of the total group). Patients (37) were euparathyroid at follow-up (an average of 4.6 yr postoperatively). Only 1 individual, a member of a kindred with multiple endocrine neoplasia (MEN), type 1, had persistent HPT; but 4 other patients with MEN syndromes were among the group cured by surgery. The findings support the notion that > 1 adenoma may occasionally be found in primary HPT, and that selective excision of the enlarged glands with preservation of the normal parathyroid glands constitutes adequate treatment. One possible exception to this rule is the patient with either familial HPT or 1 of the MEN syndromes; subtotal parathyroidectomy is preferred in this situation.

This publication has 0 references indexed in Scilit: