School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Department of Otolaryngology-Head & Neck Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Head Neck. 2023 Mar;45(3):706-720. doi: 10.1002/hed.27287. Epub 2022 Dec 23.
Intrathyroidal parathyroid adenomas (IPAs) are a rare cause of primary hyperparathyroidism. They are often difficult to localize preoperatively and intraoperatively, making diagnosis and treatment challenging. Current data on IPAs are sparse and fragmented in the literature. This makes it difficult to compare the effectiveness of different imaging and surgical techniques. To address this issue, this scoping review maps the literature on IPAs, focusing on four domains: clinical presentation, current localization methods, different surgical techniques, and histopathological features. A search of MEDLINE, Embase, and the Cochrane Library was conducted, with 19 studies meeting the inclusion criteria. The characteristics of IPAs on ultrasound, fine-needle aspiration, CT, MRI, sestamibi-based techniques, and selective venous sampling are summarized. Emerging imaging modalities, including autofluorescence, are introduced. Surgical methods and intraoperative factors that correlate with high success rates for removal are highlighted. This review also identifies gaps in knowledge to guide further research into this area.
甲状腺内甲状旁腺腺瘤（IPAs）是原发性甲状旁腺功能亢进的罕见病因。它们在术前和术中常常难以定位，这使得诊断和治疗具有挑战性。目前关于 IPA 的数据在文献中稀少且分散。这使得比较不同成像和手术技术的效果变得困难。为了解决这个问题，本范围综述对 IPA 的文献进行了映射，重点关注四个领域：临床表现、当前定位方法、不同的手术技术和组织病理学特征。对 MEDLINE、Embase 和 Cochrane 图书馆进行了检索，符合纳入标准的研究有 19 项。总结了超声、细针抽吸、CT、MRI、锝-99m sestamibi 技术和选择性静脉取样中 IPA 的特征。引入了新兴的成像方式，包括自发荧光。突出了与高切除成功率相关的手术方法和术中因素。本综述还确定了知识空白，以指导该领域的进一步研究。
