The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism.
BACKGROUND
Operation for multiple endocrine neoplasia (MEN)1-related hyperparathyroidism (HPT) includes a neck exploration with resection of 3.5 or 4 parathyroid glands and transcervical thymectomy (TCT). We reviewed our experience with initial operation for primary HPT to determine the outcome and utility of routine TCT.


METHODS
All patients with MEN1 who underwent initial neck exploration from 1993 to 2007 under an institutional review board-approved protocol were reviewed.


RESULTS
We identified 66 patients with initial operation for HPT in MEN1. In 34 patients, 4 glands were found; in 32 patients, <4 glands were found. In 2 of the 34 (6%) and 17 of the 32 (53%), intrathymic parathyroid tissue was found on permanent pathology. No thymic carcinoid tissue was found in any specimen.


CONCLUSIONS
These data highlight the importance of performing TCT when <4 entopic parathyroid glands are found at first operation.
Powell
Anathea C
AC
Tumor Angiogenesis Section, Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
Alexander
H Richard
HR
Pingpank
James F
JF
Steinberg
Seth M
SM
Skarulis
Monica
M
Bartlett
David L
DL
Agarwal
Sunita
S
Cochran
Craig
C
Seidel
Geoffrey
G
Fraker
Douglas
D
Hughes
Marybeth S
MS
Jensen
Robert T
RT
Marx
Stephen J
SJ
Libutti
Steven K
SK
D000328:Adult; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000209:etiology / Q000601:surgery*; D008297:Male; D018761:Multiple Endocrine Neoplasia Type 1 / Q000150:complications*; D009333:Neck; D013934:Thymectomy / Q000379:methods*