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Xu SY, Wang Y, Xie Q, Wu HY
Correspondence: Dr Hong-yan Wu, email@example.com
Parathyroid adenoma is a major cause of primary hyperparathyroidism. Treatment usually involves the surgical removal of one or more parathyroid glands. However, specific localising techniques have boosted the development of nonsurgical, minimally invasive procedures, such as percutaneous radiofrequency ablation (RFA) under ultrasonographic guidance, which are gaining popularity as a method of treatment. This paper reports two male patients who presented with hypercalcaemia (highest serum calcium level 4.56 mmol/L and 4.57 mmol/L, respectively) and hyperparathyroidism (highest serum parathyroid hormone [PTH] level 772 ng/L and > 1,900 ng/L, respectively) due to solitary parathyroid adenoma. Four days after percutaneous RFA, the serum calcium levels in both patients decreased and PTH levels showed a significant decreasing trend. Both patients recovered well with normal levels of calcium and improvement of symptoms. Thus, we conclude that RFA may be a safe and effective therapeutic option in the treatment of parathyroid adenoma.
Keywords: hypercalcaemia, intervention, parathyroid adenoma, radiofrequency ablation
Singapore Med J 2013; 54(7): e137–e140; http://dx.doi.org/10.11622/smedj.2013092
|1. AACE/AAES Task Force on Primary Hyperparathyroidism. The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons position statement on the diagnosis and management of primary hyperparathyroidism. Endocr Pract 2005; 11:49-54.
|2. Tahim AS, Saunders J, Sinha P. A parathyroid adenoma: benign disease presenting with hyperparathyroid crisis. Case Report Med 2010; 2010:596185.|
|3. Lindekleiv H, Due J, Thuy L, Hansen TA, Nilsen PA. [Minimally invasive treatment of primary hyperparathyroidism.] Tidsskr Nor Laegeforen 2007; 127:1204-6. Norwegian.|
|4. Jeong WK, Baek JH, Rhim H, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 2008; 18:1244-50.
|5. Tochio M, Takaki H, Yamakado K, et al. A case report of 20 lung radiofrequency ablation sessions for 50 lung metastases from parathyroid carcinoma causing hyperparathyroidism. Cardiovasc Intervent Radiol 2010; 33:657-9.
|6. Chan VO, McDermott S, Malone DE, Dodd JD. Percutaneous radiofrequency ablation of lung tumors: evaluation of the literature using evidence-based techniques. J Thorac Imaging 2011; 26:18-26.
|7. Shin KY, Heo J, Kim JY, et al. A case of hemocholecyst associated with hemobilia following radiofrequency ablation therapy for hepatocellular carcinoma. Korean J Hepatol 2011; 17:148-51.
|8. Carrafiello G, Laganà D, Mangini M, et al. Treatment of secondary hyperparathyroidism with ultrasonographically guided percutaneous radiofrequency thermoablation. Surg Laparosc Endosc Percutan Tech 2006; 16:112-6.
|9. Adda G, Scillitani A, Epaminonda P, et al. Ultrasound-guided laser thermal ablation for parathyroid adenomas: analysis of three cases with a three-year follow-up. Horm Res 2006; 65:231-4.
|10. Ahmad S, Jielani AA, Khan K, et al. Dual phase MIBI scintigraphy in diagnosis of parathyroid adenoma followed by ultrasound guided percutaneous alcoholic ablation. J Ayub Med Coll Abbottabad 2008; 20:149-51.|
|11. Orlando A, Leandro G, Olivo M, Andriulli A, Cottone M. Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials. Am J Gastroenterol 2009; 104:514-24.
|12. Bouza C, López-Cuadrado T, Alcázar R, Saz-Parkinson Z, Amate JM. Meta-analysis of percutaneous radiofrequency ablation versus ethanol injection in hepatocellular carcinoma. BMC Gastroenterology 2009; 9:31.
|13. Akinci B, Demir T, Yener S, et al. Beneficial effect of endocrinologistperformed ultrasonography on preoperative parathyroid adenoma localization. Endocr Pract 2009; 15:17-23.
|14. Lo CY, Lang BH, Chan WF, Kung AW, Lam KS. A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism. Am J Surg 2007; 193:155-9.
|15. Vazquez BJ, Richards ML. Imaging of the thyroid and parathyroid glands. Surg Clin North Am 2011; 91:15-32.