Rioja Paula, Mateu Germán, Lorente-Poch Leyre, Sancho Juan J, Sitges-Serra Antonio
Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain.
Gland Surg. 2015 Aug;4(4):295-300. doi: 10.3978/j.issn.2227-684X.2015.04.14.
Undescended glands are a rare cause of primary and secondary hyperparathyroidism (HPT), but they are more common, however, among patients with recurrent HPT or those who have undergone a failed initial cervical exploration. The currently development of more precise noninvasive imaging techniques has improved the results of preoperative diagnosis of these ectopic lesions.
The operative reports of patients undergoing parathyroidectomy at our institution were reviewed to identify patients with an undescended parathyroid gland adenomas. Demographic, clinical, imaging and surgical variables were recorded.
Three patients were included: 2/598 parathyroidectomies performed for primary HPT and 1/93 performed for secondary HPT. One case is presented as jaw tumor syndrome (JTS). All the patients had undergone at least one operation before the definitive focused surgery and represented 6% of our parathyroid reoperations. No significant complications and no recurrences were observed in the long-term follow up.
Accurate preoperative localization of these lesions was possible with noninvasive studies. High cure rate is possible through selective approach when accurate preoperative localization. Thorough knowledge of parathyroid embryology and meticulous surgical technique are essential, particularly in patients with previous unsuccessful explorations.
甲状旁腺未降是原发性和继发性甲状旁腺功能亢进症（HPT）的罕见病因，但在复发性HPT患者或初次颈部探查失败的患者中更为常见。目前更精确的非侵入性成像技术的发展提高了这些异位病变的术前诊断结果。
回顾了我院接受甲状旁腺切除术患者的手术报告，以确定甲状旁腺腺瘤未降的患者。记录人口统计学、临床、影像学和手术变量。
纳入3例患者：2例为原发性HPT行甲状旁腺切除术，共598例；1例为继发性HPT行甲状旁腺切除术，共93例。1例表现为颌骨肿瘤综合征（JTS）。所有患者在最终的聚焦手术前至少接受过一次手术，占我们甲状旁腺再次手术的6%。长期随访未观察到明显并发症和复发。
通过非侵入性研究可以对这些病变进行准确的术前定位。术前准确定位时，采用选择性方法有可能实现高治愈率。全面了解甲状旁腺胚胎学和细致的手术技术至关重要，尤其是在既往探查失败的患者中。
