Selective intra-operative parathyroid hormone in re-do neck exploration in parathyroidectomy: A case report

Henry To; Gregory Otto

doi:10.1016/j.ijscr.2019.02.031

Selective intra-operative parathyroid hormone in re-do neck exploration in parathyroidectomy: A case report

Int J Surg Case Rep. 2019:57:1-4. doi: 10.1016/j.ijscr.2019.02.031. Epub 2019 Feb 28.

Authors

Henry To¹, Gregory Otto²

Affiliations

¹ Department of Surgery, Lyell McEwin Hospital, Haydown Rd., Elizabeth Vale, South Australia, 5112, Australia. Electronic address: henry.to@nh.org.au.
² Department of Surgery, Lyell McEwin Hospital, Haydown Rd., Elizabeth Vale, South Australia, 5112, Australia.

Abstract

Introduction: Intra-operative parathyroid hormone (I-OPTH) levels are an adjunct used in parathyroid surgery which provides assurance that parathyroidectomy surgery is complete and has removed the hypersecreting gland.

Presentation of case: A 78 year old female with no localisation on pre-operative imaging and had previous hemithyroidectomy. I-OPTH was used to guide the side and timing for completion of exploration, factors which reduced operative time, operative cost and avoided potential complications.

Discussion: Routine and selective I-OPTH may be used to guide parathyroidectomy, and this case highlights the methodology of use in a selective challenging case. Appropriate application and interpretation of results must be achieved to ensure adequate completion of surgery and cure for the patient.

Conclusion: Selective use of I-OPTH guides parathyroidectomy in challenging cases, and can be time and cost-effective when used appropriately.

Keywords: Case report; Intra-operative assay; Non-localised parathyroid; Parathyroid adenoma; Parathyroidectomy.