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Recurrent Parathyroid Adenoma at the Same Site Importance of ROLL

Received: 1 December 2020    Accepted: 15 December 2020    Published: 15 January 2021
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Abstract

Background: Recurrent hyperparathyroidism is defined by the re-appearance of parathyroid hormone (PTH) and high blood calcium levels more than 6 months after successful initial surgery for primary hyperparathyroidism. Many causes are associated with recurrent hyperparathyroidism and one of the main reasons is the presence of parathyroid adenoma. Radio-guided occult lesion localization (ROLL) has emergent role in per-operative localization of pathological lesions. ROLL has established role in breast cancer, axillary and thyroid surgery. ROLL is a valuable addition in parathyroid exploration especially in small sized parathyroid adenomas. ROLL is safe and efficient techniques helping in more accurate lesion centricity. Case presentation A 35 years old female was referred to our Nuclear Medicine department due to recurrently raised Calcium and PTH levels. She had complaints of generalized aches and pains with no visible neck nodule. Her Ultrasound neck showed no abnormal lesion while 99m Tc MIBIscan showed an area of increased radiotracer uptake in the right side of neck. Focused surgical neck exploration was done and a parathyroid adenoma was removed. Conclusions Parathyroid adenoma is a most common cause of primary hyperparathyroidism and usually presents symptomatically with high calcium and parathyroid hormone levels. Parathyroid adenoma is diagnosed by imaging and laboratory studies. One stop management is the surgical removal of 3 and a half removal of parathyroid gland and only sparing half of the gland.

Published in International Journal of Diabetes and Endocrinology (Volume 6, Issue 1)
DOI 10.11648/j.ijde.20210601.13
Page(s) 9-15
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Recurrence, Parathyroid Adenoma, Raised PTH, Serum Calcium, ROLL

References
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  • APA Style

    Ayesha Ammar, Kahkashan Bashir, Muhammad Faheem, Sadaf Batool, Noreen Marwat, et al. (2021). Recurrent Parathyroid Adenoma at the Same Site Importance of ROLL. International Journal of Diabetes and Endocrinology, 6(1), 9-15. https://doi.org/10.11648/j.ijde.20210601.13

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    ACS Style

    Ayesha Ammar; Kahkashan Bashir; Muhammad Faheem; Sadaf Batool; Noreen Marwat, et al. Recurrent Parathyroid Adenoma at the Same Site Importance of ROLL. Int. J. Diabetes Endocrinol. 2021, 6(1), 9-15. doi: 10.11648/j.ijde.20210601.13

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    AMA Style

    Ayesha Ammar, Kahkashan Bashir, Muhammad Faheem, Sadaf Batool, Noreen Marwat, et al. Recurrent Parathyroid Adenoma at the Same Site Importance of ROLL. Int J Diabetes Endocrinol. 2021;6(1):9-15. doi: 10.11648/j.ijde.20210601.13

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  • @article{10.11648/j.ijde.20210601.13,
      author = {Ayesha Ammar and Kahkashan Bashir and Muhammad Faheem and Sadaf Batool and Noreen Marwat and Naseer Ahmed and Shazia Fatima},
      title = {Recurrent Parathyroid Adenoma at the Same Site Importance of ROLL},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {6},
      number = {1},
      pages = {9-15},
      doi = {10.11648/j.ijde.20210601.13},
      url = {https://doi.org/10.11648/j.ijde.20210601.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210601.13},
      abstract = {Background: Recurrent hyperparathyroidism is defined by the re-appearance of parathyroid hormone (PTH) and high blood calcium levels more than 6 months after successful initial surgery for primary hyperparathyroidism. Many causes are associated with recurrent hyperparathyroidism and one of the main reasons is the presence of parathyroid adenoma. Radio-guided occult lesion localization (ROLL) has emergent role in per-operative localization of pathological lesions. ROLL has established role in breast cancer, axillary and thyroid surgery. ROLL is a valuable addition in parathyroid exploration especially in small sized parathyroid adenomas. ROLL is safe and efficient techniques helping in more accurate lesion centricity. Case presentation A 35 years old female was referred to our Nuclear Medicine department due to recurrently raised Calcium and PTH levels. She had complaints of generalized aches and pains with no visible neck nodule. Her Ultrasound neck showed no abnormal lesion while 99m Tc MIBIscan showed an area of increased radiotracer uptake in the right side of neck. Focused surgical neck exploration was done and a parathyroid adenoma was removed. Conclusions Parathyroid adenoma is a most common cause of primary hyperparathyroidism and usually presents symptomatically with high calcium and parathyroid hormone levels. Parathyroid adenoma is diagnosed by imaging and laboratory studies. One stop management is the surgical removal of 3 and a half removal of parathyroid gland and only sparing half of the gland.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Recurrent Parathyroid Adenoma at the Same Site Importance of ROLL
    AU  - Ayesha Ammar
    AU  - Kahkashan Bashir
    AU  - Muhammad Faheem
    AU  - Sadaf Batool
    AU  - Noreen Marwat
    AU  - Naseer Ahmed
    AU  - Shazia Fatima
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    DO  - 10.11648/j.ijde.20210601.13
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 9
    EP  - 15
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20210601.13
    AB  - Background: Recurrent hyperparathyroidism is defined by the re-appearance of parathyroid hormone (PTH) and high blood calcium levels more than 6 months after successful initial surgery for primary hyperparathyroidism. Many causes are associated with recurrent hyperparathyroidism and one of the main reasons is the presence of parathyroid adenoma. Radio-guided occult lesion localization (ROLL) has emergent role in per-operative localization of pathological lesions. ROLL has established role in breast cancer, axillary and thyroid surgery. ROLL is a valuable addition in parathyroid exploration especially in small sized parathyroid adenomas. ROLL is safe and efficient techniques helping in more accurate lesion centricity. Case presentation A 35 years old female was referred to our Nuclear Medicine department due to recurrently raised Calcium and PTH levels. She had complaints of generalized aches and pains with no visible neck nodule. Her Ultrasound neck showed no abnormal lesion while 99m Tc MIBIscan showed an area of increased radiotracer uptake in the right side of neck. Focused surgical neck exploration was done and a parathyroid adenoma was removed. Conclusions Parathyroid adenoma is a most common cause of primary hyperparathyroidism and usually presents symptomatically with high calcium and parathyroid hormone levels. Parathyroid adenoma is diagnosed by imaging and laboratory studies. One stop management is the surgical removal of 3 and a half removal of parathyroid gland and only sparing half of the gland.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Pakistan Atomic Energy Cancer Hospital, Nori, Islamabad

  • Pakistan Atomic Energy Cancer Hospital, Nori, Islamabad

  • Pakistan Atomic Energy Cancer Hospital, Nori, Islamabad

  • Pakistan Atomic Energy Cancer Hospital, Nori, Islamabad

  • Pakistan Atomic Energy Cancer Hospital, Nori, Islamabad

  • Pakistan Atomic Energy Cancer Hospital, Nori, Islamabad

  • Pakistan Atomic Energy Cancer Hospital, Nori, Islamabad

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