Do giant parathyroid adenomas represent a distinct clinical entity?

Philip M Spanheimer; Andrew J Stoltze; James R Howe; Sonia L Sugg; Geeta Lal; Ronald J Weigel

doi:10.1016/j.surg.2013.05.013

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Do giant parathyroid adenomas represent a distinct clinical entity?

Journal article

Peer reviewed

Do giant parathyroid adenomas represent a distinct clinical entity?

Philip M Spanheimer, Andrew J Stoltze, James R Howe, Sonia L Sugg, Geeta Lal and Ronald J Weigel

Surgery, Vol.154(4), pp.714-719

10/2013

DOI: 10.1016/j.surg.2013.05.013

PMCID: PMC3787983

PMID: 23978594

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http://doi.org/10.1016/j.surg.2013.05.013View

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Abstract

The size of abnormal parathyroid glands in patients with primary hyperparathyroidism (PHPT) is highly variable, but the clinical significance of giant glands is unknown. We reviewed 300 consecutive patients after parathyroidectomy for PHPT. We compared patients with giant parathyroid adenomas (weight ≥95th percentile) with the remaining patients. Giant adenomas were defined as weight ≥95th percentile or 3.5 g (median, 0.61; range, 0.05-29.93). Patients with giant adenomas had a greater mean preoperative calcium level, greater mean parathyroid hormone (PTH) level, and were less likely to have multiglandular or symptomatic disease. Giant adenomas were successfully localized on imaging in 87% of patients, which was not increased over other patients (82%). There were no differences between the groups in age, gender, gland location, or the incidence of persistent or recurrent hyperparathyroidism. Finally, giant glands had an increased incidence of symptomatic postoperative hypocalcemia, including 1 patient who required rehospitalization after removal of a giant gland. Giant parathyroid adenomas have a distinct presentation characterized by single gland disease and lower incidence of symptoms despite increased levels of calcium and PTH. Additionally, after resection of a giant adenoma, patients are more likely to develop symptomatic hypocalcemia.

Adenoma - surgery

Parathyroid Neoplasms - pathology

Humans

Middle Aged

Male

Parathyroid Hormone - blood

Parathyroid Neoplasms - surgery

Parathyroid Neoplasms - blood

Calcium - blood

Adenoma - blood

Adult

Female

Aged

Details

Title: Subtitle: Do giant parathyroid adenomas represent a distinct clinical entity?
Creators: Philip M Spanheimer - Department of Surgery, University of Iowa, Iowa City, IA
Andrew J Stoltze
James R Howe
Sonia L Sugg
Geeta Lal
Ronald J Weigel
Resource Type: Journal article
Publication Details: Surgery, Vol.154(4), pp.714-719
DOI: 10.1016/j.surg.2013.05.013
PMID: 23978594
PMCID: PMC3787983
NLM abbreviation: Surgery
ISSN: 0039-6060
eISSN: 1532-7361
Publisher: United States
Grant note: T32 CA148062 / NCI NIH HHS T32CA148062 / NCI NIH HHS
Language: English
Date published: 10/2013
Academic Unit: Molecular Physiology and Biophysics; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Surgery; Biochemistry and Molecular Biology
Record Identifier: 9984051598502771

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