title: The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism.
abstract: 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.
authors.affiliation: Tumor Angiogenesis Section, Surgery Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Anathea C
authors.initials: AC
authors.lastname: Powell
authors.forename: H Richard
authors.initials: HR
authors.lastname: Alexander
authors.forename: James F
authors.initials: JF
authors.lastname: Pingpank
authors.forename: Seth M
authors.initials: SM
authors.lastname: Steinberg
authors.forename: Monica
authors.initials: M
authors.lastname: Skarulis
authors.forename: David L
authors.initials: DL
authors.lastname: Bartlett
authors.forename: Sunita
authors.initials: S
authors.lastname: Agarwal
authors.forename: Craig
authors.initials: C
authors.lastname: Cochran
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Seidel
authors.forename: Douglas
authors.initials: D
authors.lastname: Fraker
authors.forename: Marybeth S
authors.initials: MS
authors.lastname: Hughes
authors.forename: Robert T
authors.initials: RT
authors.lastname: Jensen
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Marx
authors.forename: Steven K
authors.initials: SK
authors.lastname: Libutti
mesh_terms: 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*