The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism

Anathea C. Powell, H. Richard Alexander, James F. Pingpank, Seth M. Steinberg, Monica Skarulis, David L. Bartlett, Sunita Agarwal, Craig Cochran, Geoffrey Seidel, Douglas Fraker, Marybeth S. Hughes, Robert T. Jensen, Stephen J. Marx, Steven K. Libutti

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Operation for multiple endocrine neoplasia (MEN)1-related hyperparathyroidism (HPT) includes a neck exploration with resection of 3.5 or 4 parathyroid glands and transcervical thymectomy (TCT). We reviewed our experience with initial operation for primary HPT to determine the outcome and utility of routine TCT. Methods: All patients with MEN1 who underwent initial neck exploration from 1993 to 2007 under an institutional review board-approved protocol were reviewed. Results: We identified 66 patients with initial operation for HPT in MEN1. In 34 patients, 4 glands were found; in 32 patients, <4 glands were found. In 2 of the 34 (6%) and 17 of the 32 (53%), intrathymic parathyroid tissue was found on permanent pathology. No thymic carcinoid tissue was found in any specimen. Conclusion: These data highlight the importance of performing TCT when <4 entopic parathyroid glands are found at first operation.

Original languageEnglish (US)
Pages (from-to)878-884
Number of pages7
JournalSurgery
Volume144
Issue number6
DOIs
StatePublished - Dec 2008
Externally publishedYes

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Multiple Endocrine Neoplasia
Thymectomy
Multiple Endocrine Neoplasia Type 1
Parathyroid Glands
Neck
Primary Hyperparathyroidism
Hyperparathyroidism
Research Ethics Committees
Carcinoid Tumor
Pathology
Hyperparathyroidism 1

ASJC Scopus subject areas

  • Surgery

Cite this

Powell, A. C., Alexander, H. R., Pingpank, J. F., Steinberg, S. M., Skarulis, M., Bartlett, D. L., ... Libutti, S. K. (2008). The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism. Surgery, 144(6), 878-884. https://doi.org/10.1016/j.surg.2008.08.031

The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism. / Powell, Anathea C.; Alexander, H. Richard; Pingpank, James F.; Steinberg, Seth M.; Skarulis, Monica; Bartlett, David L.; Agarwal, Sunita; Cochran, Craig; Seidel, Geoffrey; Fraker, Douglas; Hughes, Marybeth S.; Jensen, Robert T.; Marx, Stephen J.; Libutti, Steven K.

In: Surgery, Vol. 144, No. 6, 12.2008, p. 878-884.

Research output: Contribution to journalArticle

Powell, AC, Alexander, HR, Pingpank, JF, Steinberg, SM, Skarulis, M, Bartlett, DL, Agarwal, S, Cochran, C, Seidel, G, Fraker, D, Hughes, MS, Jensen, RT, Marx, SJ & Libutti, SK 2008, 'The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism', Surgery, vol. 144, no. 6, pp. 878-884. https://doi.org/10.1016/j.surg.2008.08.031
Powell AC, Alexander HR, Pingpank JF, Steinberg SM, Skarulis M, Bartlett DL et al. The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism. Surgery. 2008 Dec;144(6):878-884. https://doi.org/10.1016/j.surg.2008.08.031
Powell, Anathea C. ; Alexander, H. Richard ; Pingpank, James F. ; Steinberg, Seth M. ; Skarulis, Monica ; Bartlett, David L. ; Agarwal, Sunita ; Cochran, Craig ; Seidel, Geoffrey ; Fraker, Douglas ; Hughes, Marybeth S. ; Jensen, Robert T. ; Marx, Stephen J. ; Libutti, Steven K. / The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism. In: Surgery. 2008 ; Vol. 144, No. 6. pp. 878-884.
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AB - Background: Operation for multiple endocrine neoplasia (MEN)1-related hyperparathyroidism (HPT) includes a neck exploration with resection of 3.5 or 4 parathyroid glands and transcervical thymectomy (TCT). We reviewed our experience with initial operation for primary HPT to determine the outcome and utility of routine TCT. Methods: All patients with MEN1 who underwent initial neck exploration from 1993 to 2007 under an institutional review board-approved protocol were reviewed. Results: We identified 66 patients with initial operation for HPT in MEN1. In 34 patients, 4 glands were found; in 32 patients, <4 glands were found. In 2 of the 34 (6%) and 17 of the 32 (53%), intrathymic parathyroid tissue was found on permanent pathology. No thymic carcinoid tissue was found in any specimen. Conclusion: These data highlight the importance of performing TCT when <4 entopic parathyroid glands are found at first operation.

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