Introduction: Minimally invasive surgery is an alternative surgical approach for primary hyperparathyroidism with less surgical trauma and anesthesia complications. Neck ultrasonography and scintigraphy are still the first step tools for localisating parathyroid lesions. Intact parathyroid hormone (PH) determination in washout samples is really very useful when parathyroid lesions can not be easily distinguished from thyroid lesions or sometimes lymph nodes.
Method: In our clinic, we performed ultrasonography guided parathyroid fine needle aspiration procedure for 119 patients diagnosed with primary hyperparathyroidism between January 2005 and January 2016. Intact parathyroid hormone determination was performed in washout samples. 80 of the study group also had a parathyroid scintigraphy. All of the patients underwent parathyroid surgery.
Results: In 106 of the study group had positive parathyroid hormone washout (phw) results according to blood PH levels. Significant difference was achieved in localisation of the lesion (p:0.006), serum calcium levels (p:0.01) and PHW levels (p<0.001) between washout negative and positive group. No difference was observed in gender, age, presence of stone, levels of serum phosphorus, creatinin, alkaline phosphatase, parathyroid hormone, vitamin D and 24 h urinary calcium levels. 28 patients in the scintigraphy group had negative scan whereas 47 of them had both scintigraphy and PHW positive. 24 of the patients had positive PHW results but negative scintiscans.
Conclusion: The present study represents that ultrasonography combined with PHW evaluation seems to be more diagnostic according to parathyroid scintigraphy.
20 - 23 May 2017
European Society of Endocrinology