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A Journal on Surgery

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Chirurgia 2011 February;24(1):1-4

language: Italian

Radioguided surgery in recurrent hyperparathyroidism after autotransplantation

Ardito G., Revelli L., Giustozzi E., Traini E., Boscherini M., Insalaco C., Zagaria L., Giordano A.

Dipartimento di Chirurgia, Università Cattolica del Sacro Cuore, Roma, Italia


Aim. One of the surgical treatment options in secondary hyperparathyroidism is total parathyroidectomy with implantation of parathyroid tissue in the forearm (autotransplantation). Recurrence of the condition is probably caused by hyperplasia of remnants of implanted parathyroid tissue. In such cases, imaging with Tc-99m scintigraphy can reveal elevated uptake at the implant site.
Methods. A 38-year-old man was treated because of recurrent hyperparathyroidism caused by hyperplasia of parathyroid tissue transplanted in the forearm after total parathyroidectomy with autotransplantation performed about seven years earlier.
Results. During the previous operation, no landmark had been placed to locate the parathyroid tissue implant in the forearm. The radio probe rapidly detected the hypercaptating lesion, thus permitting complete removal of the anomalous tissue.
Conclusions. The marked decrease in intraoperative parathormone levels confirmed successful outcome with use of this technique.

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