Objective: This study aimed to evaluate the bone microstructure to determine whether curative surgery of primary hyperparathyroidism produces changes in bone mineral density (BMD), trabecular bone score (TBS), and three-dimensional (3D) dual x-ray absorptiometry (DXA) parameters and whether these changes are comparable.
Methods: We retrospectively studied 85 patients (60 women and 25 men, 60.4 ± 12.5 years) diagnosed with primary hyperparathyroidism and undergoing parathyroidectomy. Mean percent changes in BMD (lumbar spine [LS], femoral neck [FN], total hip [TH], and 1/3 radius), TBS and 3D-DXA parameters (trabecular volumetric BMD (vBMD), cortical vBMD, integral vBMD, cortical surface density (sBMD), and cortical thickness at TH) after surgery (12, 24, and/or 36 months) were calculated and compared, and we sought the determinants of these changes.
Results: After parathyroidectomy, BMD presented statistically significant mean increases in LS, FN, and TH during the first 3 years after surgery (P < .001), accompanied by an improvement in all 3D-DXA parameters, but there were no significant changes in 1/3 radius BMD or TBS. Cortical sBMD, trabecular vBMD, and integral vBMD reached mean increases of similar magnitude to those of FN and TH BMD. Age and preoperative serum levels of parathyroid hormone and carboxy-terminal telopeptide of type 1 collagen were significantly associated with percent changes after surgery.
Conclusion: We found a benefit of parathyroidectomy for bone, with significant percent increases in LS, FN, and TH BMD up to the third year after surgery, and a qualitative benefit for the hip in both its trabecular and cortical compartments and bone strength.
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http://dx.doi.org/10.1016/j.eprac.2024.01.004 | DOI Listing |
Parathyroid adenoma is a common endocrine disorder, but its intrathyroid presentation is relatively rare. The traditional approach, such as thyroid blind lobectomy, is the most frequent modality of treatment due to the possible unclear localization of the adenoma in the preoperative workup. This increases the risk of unnecessary probability of hypothyroidism.
View Article and Find Full Text PDFCir Esp (Engl Ed)
December 2024
Servicio de Medicina Nuclear, Hospital Universitario de Navarra, Pamplona, Spain.
Objective: To evaluate whether a radioguided approach allows a higher intraoperative detection rate of adenoma and a minimally invasive parathyroidectomy (MIP), with the same or better cure rate of hyperparathyroidism secondary to parathyroid adenoma.
Methods: This was an observational, prospective, single-center study involving 254 consecutive patients with primary hyperparathyroidism, between 2017 and 2022. A total of 258 procedures were performed: 129 non radioguided (NRS) and 129 radioguided (RS) (112 with intravenous 99 mTc- MIBI and 17 with ultrasound-guided intralesional 99 mTc-MAA injection) with an intraoperative gamma probe and gamma camera.
EJNMMI Rep
December 2024
Department of Oncology and Nuclear Medicine, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.
Brown tumors or osteitis fibrosa cystica are a rare bone metabolism disorder that may mimic cancer metastasis. It represents a late manifestation of prolonged and mostly unrecognized hyperparathyroidism. In this case report we present a 44-year-old female patient with multiple lesions detected on bone scintigraphy and F- FDG-PET/CT, initially interpreted as a bone metastatic disease, rather than multiple gigantocellular bone tumors.
View Article and Find Full Text PDFFront Oncol
December 2024
Department of Nephrology, St. Georg Hospital, Leipzig, Germany.
Background: Malignant hypercalcemia is usually caused by osteolytic processes of metastases, production of parathormone-related peptide, or secretion of 1,25-dihydroxyvitamin D. Ectopic PTH (parathyroid hormone) production by malignancy is very unusual.
Methods: Case report and review of the literature.
Endocrine
December 2024
Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Objective: Primary hyperparathyroidism (PHPT) is characterized by elevated parathyroid hormone (PTH) levels and hypercalcemia. Although research suggests a potential link between PTH and lipid metabolism, the evidence remains inconclusive. This study investigated lipid metabolism and fat distribution in PHPT patients.
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