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Research Article| Volume 116, ISSUE 6, P959-965, December 1994

Use of preoperative fine-needle aspiration in patients undergoing reoperation for primary hyperparathyroidism

  • Mark P. MacFarlane
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • Douglas L. Fraker
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • Thomas H. Shawker
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • Jeffrey A. Norton
    Footnotes
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • John L. Doppman
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • Richard A. Chang
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • Monica C. Skarulis
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • Stephen J. Marx
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • Allen M. Spiegel
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
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  • H. Richard Alexander
    Correspondence
    Reprint requests: H. R. Alexander, MD, Surgical Metabolism Section, Surgery Branch, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Room 21117, Bethesda, MD 20892.
    Affiliations
    From the Surgical Metabolism Section, Surgery Branch, National Cancer Institute, Bethesda, Md., USA

    Metabolic Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., USA

    Department of Radiology, Henry M. Jackson Foundation, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md., USA
    Search for articles by this author
  • Author Footnotes
    a Current address: Department of Surgery, Washington University School of Medicine, St. Louis, Mo.
DOI:https://doi.org/10.5555/uri:pii:0039606094902909
Use of preoperative fine-needle aspiration in patients undergoing reoperation for primary hyperparathyroidism
Previous ArticleCost of unsuccessful surgery for primary hyperparathyroidism
Next ArticleParathyroid imaging with technetium-99m-sestamibi: An initial institutional experience
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      Abstract

      Background. Neck reexploration for primary hyperparathyroidism has a lower success rate and greater morbidity than initial exploration because of scarring and distortion of tissue planes and the possibility of a parathyroid neoplasm located in an ectopic or unusual position. Although the use of standard noninvasive imaging studies for reoperative parathyroid surgical procedure is well accepted, the use of invasive studies to localize parathyroid neoplasms, particularly percutaneous aspiration of potential lesions, is controversial. In this report we analyze the results and morbidity in patients undergoing fine-needle aspiration before neck reexploration.
      Methods. From 1982 to 1993, 255 patients underwent reexploration for persistent or recurrent hyperparathyroidism at the National Institutes of Health. Of these 255 patients 42 underwent 44 preoperative fine-needle aspirations by ultrasonography or computed tomography guidance in an attempt to localize a parathyroid neoplasm. The aspirated contents were then analyzed for parathyroid hormone content.
      Results. Of the 44 aspirations 26 (59%) were true positives with no false positives. Of 18 negative fine-needle aspirations, 11 (25%) were false negatives, and seven (16%) were true negatives. The specificity and sensitivity of percutaneous fine-needle aspiration were 100% and 70%, respectively.
      Conclusions. Percutaneous fine-needle aspiration for parathyroid hormone is a safe, well-tolerated technique that is highly specific and allows a directed surgical resection avoiding further invasive workup when the aspirate is positive.
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      Article info

      Footnotes

      ☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606094902909

      Copyright

      © 1994 Published by Elsevier Inc.

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