Giant versus regular parathyroid adenoma: A retrospective comparative study
| Autor: | Haitham Odat, Wisam Al-Gargaz, Shadi Hamouri, Hassan M. Abushukair, Raneem Abuashour |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Parathyroidectomy
medicine.medical_specialty Younger age Screening test Adenoma Primary hyperparathyroidism medicine.medical_treatment 030230 surgery Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine otorhinolaryngologic diseases medicine Cohort Study Parathyroid adenoma business.industry Clinical course General Medicine medicine.disease Predictive value 030220 oncology & carcinogenesis Calcium Surgery business PTH |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Background A fraction of Parathyroid Adenoma (PTA) is considered giant if they weigh more than 3.5 g. There is no clear consensus whether this subgroup has a distinct clinical or biochemical presentation that could have implications on PTA localization and management. In this study, we investigate the difference between regular and giant PTA patients regarding their clinical and laboratory findings as well as their postoperative outcomes. Materials and methods Clinical and PTA-related data were retrospectively retrieved from all patients undergoing parathyroidectomy from 2010 to 2019 at our hospital. Results A total number of 84 PTA (Females 76.2%) patients were included, of which 24 (28.6%) qualified as a giant with a mean weight of 7.86 g and the rest were regular adenomas (71.4%) with a mean weight of 1.45 g. Giant adenomas were more likely to present at a younger age compared to regular adenoma patients, (44.4 vs 50.8, P = 0.053, D = 0.470). Preoperative PTH levels were significantly higher in the giant PTA group (650.8 vs 334.2 pg/mL, P = 0.044, r = 0.22). Hospital stay was on average 1.6 days longer in giant PTA patients compared to regular PTA patients. Conclusion Giant PTA compromised a significant percentage of all adenomas, which was higher than what is reported in the literature and might reflect a delay in diagnosis and lack of screening tests. Both giant and regular adenomas seem to run a similar clinical course, yet biochemical abnormalities in PTH levels may have a predictive value for adenoma weight. Highlights • Our sample included a high percentage of giant PTA compared to the literature. This might reflect a delay in diagnosis. • Despite the difference in size, both giant and regular adenomas seem to run a similar clinical course, and the success of surgical treatment was found to be comparable. • Biochemical abnormalities in PTH levels could have a potential role in predicting the weight and size of PTA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|