The high percentage of recurrences after standard surgical procedures The high percentage of recurrences after standard surgical procedures i.
Fortythree patients with RHP underwent surgery between Parameters studies included demographics, preoperative and follow-up laboratory tests, surgical techniques, pathology papillary thyroid cancer hypercalcemia and postoperative immediate and medium term results.
Main indications for PTx were severe bone disease, soft tissue calciphycations, neuro muscular phenomena, grossly elevated iPTH and sometimes hypercalcemia. TPTx was done in 12 patients, the 13th one suffering a completion PTx one year after outward exeresis of only two glands.
Postoperatively the majority of symptoms markedly improved and the values of calcaemia, phosphatemia and alkaline phosphatasis normalised together with low or no measurable level of iPTH. One patient required a papillary thyroid cancer hypercalcemia for a cervical hematoma but no one presented permanent hypocalcemia or recurrent hyperparathyroidism. Pathology revealed nodular hyperplasia in all the cases, a parathyroid carcinoma but also an incidental thyroid papillary microcarcinoma in a complementary thyroidectomy.
TPTx alone proves to be an equally safe and successful as another techniques currently used in management of RHP eliminating the hyperparathyroid status but being superior with regard to aparition of recurrences. The procedure is indicated especially in cases with aggressive, refractory forms of Papillary thyroid cancer hypercalcemia without the prospect of renal transplantation.