Abstract

FUENTES VALDES, Edelberto et al. Initial experience in radio-guided parathyroid surgery. Rev Cubana Cir [online]. 2014, vol.53, n.1, pp.1-11. ISSN 0034-7493.

Introduction: ^99mTc-MIBI scanning allows the non-invasive preoperative location and facilitates the minimally invasive access to patients with primary hyperparathyroidism. Objectives: to describe the initial results of ^99mTc-MIBI parathyroid scanning in patients suffering primary hyperparathyroidism. Methods: from May 2007 through February 2010, ten patients with hyperparathyroidism were operated on. A female patient with multiple endocrine neoplasia syndrome was excluded from the study. The mean age was 46.3 years (32-70 years). Females predominated (6). The main symptoms were bone aches, weakness, headache and nephric colic. One patient presented with multiple brown tumors. The most common associated disease was blood hypertension. These patients were followed-up for 25 to 28 months (average 45.3 months). Results: one of the two patients undergoing resurgery for persistent hyperparathyroidism presented with hypoparathyroidsm posoperatively (both suffered multinodular thyroid disease). Of a total of 12 sick glands, 11 were lower glands (9 left and 2 right) and one upper left gland. The scanning sensitivity was 83% and the specificity was 100 % whereas the echography values were 34.6 % and 96 %, respectively. Neither complications nor deaths were observed. With the average follow-up of 45.3 months (25-28 months), all the patients were eucalcemic. Conclusions: preoperative ^99mTc-MIBI scanning sensitivity allows achieving satisfactory results in patients with hyperparathyroidism and treated with minimally invasive techniques. The patients with nodular thyroid disease should be carefully evaluated due to positive false risk.

Keywords : primary hyperparathyroidism; radio-guided parathyroid surgery; ^99mTc-MIBI scanning; hypercalcemia.

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