대한두경부종양학회지 (Korean Journal of Head & Neck Oncology)

  • 제39권2호
  • /
  • Pages.27-30
  • /
  • 2023
  • /
  • 1229-5183(pISSN)
  • /
  • 2586-2553(eISSN)
대한두경부종양학회 (The Korean Society for Head and Neck Oncology)
권호 표지
DOI QR코드

DOI QR Code

갑상선 전절제술 과거력이 있는 부갑상선 선종 환자에서 수술 중 초음파 검사를 이용한 최소침습 부갑상선 절제술 1예

Minimally Invasive Parathyroidectomy using Intraoperative Ultrasonography in Parathyroid Adenoma Patients with a History of Total Thyroidectomy

  • 남윤빈 (국민건강보험 일산병원 이비인후과) ;
  • 정현택 (국민건강보험 일산병원 이비인후과) ;
  • 이상목 (국민건강보험 일산병원 이비인후과) ;
  • 김지훈 (국민건강보험 일산병원 이비인후과)
  • Yunbin Nam (Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital) ;
  • Hyun Taek Jung (Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital) ;
  • Sang Mok Lee (Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital) ;
  • Ji-Hoon Kim (Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital)
  • 투고 : 2023.06.29
  • 심사 : 2023.07.10
  • 발행 : 2023.11.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

A 65-year-old patient who underwent total thyroidectomy 10 years ago was suspected of having a parathyroid adenoma, and minimally invasive parathyroidectomy was planned. Preoperative ultrasonography(USG) and 99mTc MIBI scan indicated a left lower parathyroid lesion. In the first operation, intraoperative parathyroid hormone monitoring (IOPTH) was not possible due to hospital circumstances. Although no adenomatous lesion was found in the expected surgical field, surgery was completed after removing lesions around the left lower parathyroid gland. However, post-surgery, parathyroid hormone did not decrease at all, so a second operation was performed with IOPTH preparation. In the second operation, intraoperative ultrasonography was performed, and a suspected adenoma lesion was removed from the left upper lesion. He has been under follow-up for 3 years without complications. Surgeon-peformed intraoperative USG and preoperative scintigraphy had advantages in determining the localization of parathyroid lesion even withiout IOPTH.

키워드

참고문헌

  1. Kowalski GJ, Bula G, Zadlo D, Gawrychowska A, Gawrychowski J. Primary hyperparathyroidism. Endokrynol Pol. 2020;71:260-270.
  2. Iwen KA, Kussmann J, Fendrich V, Lindner K, Zahn A. Accuracy of parathyroid adenoma localization by preoperative ultrasound and sestamibi in 1089 patients with primary hyperparathyroidism. World J Surg. 2022;46:2197-2205.
  3. Zammit M, Pierce K, Bailey L, Rowland M, Waghorn A, Shore S. Challenging NICE guidelines on parathyroid surgery. Surgeon. 2022;20:e105-e11.
  4. Fraker DL, Harsono H, Lewis R. Minimally invasive parathyroidectomy: Benefits and requirements of localization, diagnosis, and intraoperative PTH monitoring. long-term results. World J Surg. 2009;33:2256-2265.
  5. Wilhelm SM, Wang TS, Ruan DT, Lee JA, Asa SL, Duh QY, et al. The American association of endocrine surgeons guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016;151:959-968.
  6. Bergenfelz AO, Hellman P, Harrison B, Sitges-Serra A, Dralle H. Positional statement of the European society of endocrine surgeons (ESES) on modern techniques in pHPT surgery. Langenbecks Arch Surg. 2009;394:761-764.
  7. Quinn AJ, Ryan E J, Garry S, James DL, Boland MR, Young O, et al. Use of intraoperative parathyroid hormone in minimally invasive parathyroidectomy for primary hyperparathyroidism: A systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg. 2021;147:135-143.
  8. Choi DG, Cha JS, Kim YJ, Lee HS, Lee KD. A case of intra-thyroidal parathyroid adenoma confirmed by intraoperative near-infrared autofluorescence. Korean J Head Neck Oncol. 2023;39:53-57
  9. Uslu Erdemir R, Tasdoven I, Bayraktaroglu T, Karadeniz Cakmak G. Intraoperative ultrasound imaging and sono-scintigraphic concordance improves success rates of minimally invasive parathyroidectomy. Turk J Med Sci. 2021;51:2341-2345.
  10. Koca CF, Yildirim IO, Cicek MT, Aslan M. Successful localization of abnormal parathyroid tissue with ultrasound-guided methylene blue dye injection before surgery for metastatic or recurrent thyroid cancers and parathyroid adenomas. Am J Otolaryngol. 2023;44:103678.