Clinical Aspects of Surgically Treated Parathyroid Adenoma with Primary Hyperparathyroidism

Korean Journal of Head & Neck Oncology 2010;26(1):9-13.
Published online May 30, 2010.

Sun Ho Lyu;Kyung Seok Lee;Young Ju Cho;Il Seong Kong;Eun Jung Lee;Yun Su Yang;Ki Hwan Hong

수술적으로 치료한 원발성 부갑상선 기능항진증을 동반한 부갑상선종의 임상적 고찰

유순호;이경석;조영주;공일승;이은정;양윤수;홍기환

Abstract

Background and Objectives ：Parathyroid adenoma is a rare disease in Korea, but the incidence of para-thyroid adenoma has gradually increased due to generalized measurement of serum calcium and imaging study according to wide spread public health screening program. In previous researches, the analysis of clinical aspects were insufficient due to a few cases. The purpose of this study was to assess the clinical analysis of surgically treated parathyroid adenoma with hyperparathyroidism. Methods ：We reviewed the medical re-cords of nineteen cases of parathyroid adenoma with hyperparathyroidism. Initial symptom to visit hospital, hypercalcemia associated medical symptom, surgical outcome and complication were investigated. Serum total calcium, parathyroid hormone, phosphate, alkaline phosphatase were checked before and after surgery. Imaging study was performed with combination of radionuclide parathyroid scan, ultrasonography and neck CT scan. Results ：The initial symptoms were no symptom(6/19), pelvic pain(5/19), muscular weakness (3/19), bone pain(3/19) and palpable neck mass(2/19) in order of frequency. Serum total calcium, parathyroid hormone decreased and phosphate increased after surgery than before surgery statistically significantly. Sensi-tivities of parathyroid scan, neck ultrasonography and neck CT as preoperative localization test were 88.2%, 72.7%, 73.3% each. The most common postoperative complication was transient hypocalcemia(9/19). Con-clusion ：Similar to previous study, parathyroid adenomas have numerous clinical features and surgical treat-ment via unilateral approach with preoperatively localized single parathyroid adenoma was successful. In our study, parathyroid adenoma was predominantly detected by elevated serum calcium level with no clinical symp-tom so we need to evaluate parathyroid adenoma, if serum calcium elevated.

Key Words: Parathryoid adenoma, Hyperparathyroidism, Parathyroidectomy