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Ultrasonographic evaluation of parathyroid hyperplasia in multiple endocrine neoplasia type 1: Positive correlation between parathyroid volume and circulating parathyroid hormone concentration

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Abstract

There are few reports on parathyroid ultrasonography of multiple endocrine neoplasia type 1 (MEN1). This study investigated the ultrasonographic features of parathyroid glands in 10 patients with MEN1 who underwent preoperative neck ultrasonography and parathyroidectomy between 2006 and 2010 at Toranomon Hospital. We retrospectively analyzed clinical features, laboratory and ultrasonographic data, and pathological diagnosis. A total of 38 parathyroid glands were surgically removed (three to five glands from each patient). All removed parathyroids were pathologically diagnosed as hyperplasia. Seven cases (70.0 %) had adenomatous thyroid nodules. Twenty-five enlarged parathyroid glands (65.8 %) were detected by preoperative ultrasonography with a detection rate of 81.8 % (9/11) and 59.3 % (16/27) for patients without and with adenomatous nodules, respectively. Total parathyroid gland weight and potentially predictable total parathyroid volume by preoperative ultrasonography were significantly correlated with preoperative serum intact parathyroid hormone (iPTH) concentration (R = 0.97, P < 0.001 and R = 0.96, P < 0.001, respectively). The equation used for prediction of the total volume by ultrasonography was 15 × iPTH (pg/ml) – 1,000 and that for total weight was 20 × iPTH (pg/ml) – 1,400. Although adenomatous nodules often coexisted with MEN1 and made identification of enlarged parathyroid glands by ultrasonography difficult, the positive correlation between the predictable parathyroid volume by ultrasonography and serum iPTH suggests that their measurement is useful in the preoperative detection and localization of enlarged parathyroid glands in patients with MEN1. Furthermore, the presence of parathyroid glands that should be resected can be predicted before surgery using the equation proposed here.

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Acknowledgments

This study was funded by a grant from Okinaka Memorial Institute for Medical Research (Y.T.). We thank all staff of the Toranomon Hospital Endocrine Center for their kind help with this study.

Conflict of interest

All authors have no conflicts of interest.

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Authors and Affiliations

  1. Division of Endocrinology, Toranomon Hospital Endocrine Center, 2-2-2 Toranomon Minato-ku, 105-8470, Tokyo, Japan

    Hiroyuki Tamiya, Megumi Miyakawa, Akira Takeshita & Yasuhiro Takeuchi

  2. Division of Breast and Endocrine Surgery, Toranomon Hospital, Tokyo, Japan

    Daishu Miura

  3. Okinaka Memorial Institute for Medical Research, Tokyo, Japan

    Akira Takeshita, Daishu Miura & Yasuhiro Takeuchi

Authors
  1. Hiroyuki Tamiya
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  2. Megumi Miyakawa
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  3. Akira Takeshita
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  4. Daishu Miura
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  5. Yasuhiro Takeuchi
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Correspondence to Hiroyuki Tamiya.

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Tamiya, H., Miyakawa, M., Takeshita, A. et al. Ultrasonographic evaluation of parathyroid hyperplasia in multiple endocrine neoplasia type 1: Positive correlation between parathyroid volume and circulating parathyroid hormone concentration. J Bone Miner Metab 33, 523–529 (2015). https://doi.org/10.1007/s00774-014-0614-6

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  • DOI: https://doi.org/10.1007/s00774-014-0614-6

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