Location of parathyroid adenomas: 7-year experience.
OBJECTIVE
To determine the most common location of parathyroid adenomas.


METHODS
Data from 147 patients who underwent parathyroidectomy for primary hyperparathyroidism in Montreal at a McGill University teaching hospital between January 2001 and January 2008 were reviewed retrospectively. Patients with histopathologic confirmation of parathyroid hyperplasia were excluded from the study (n = 26). The 121 patients with confirmed adenomas were grouped according to the locations of the tumour into right superior, right inferior, left superior, left inferior, and ectopic.


RESULTS
The left inferior parathyroid glands were the most common site of adenomas. This was the case for 50 patients (41.32% [mean 0.41; 95% CI 0.324-0.506]). The right inferior parathyroid glands were the site in 40 patients (33.06% [mean 0.33; 95% CI 0.248-0.422]). The remainder of the adenomas were distributed as follows: the left superior in 19 patients (15.7% [mean 0.157; 95% CI 0.097-0.234]), the right superior in 10 patients (8.26% [mean 0.0826; 95% CI 0.040-0.147]), and the ectopic in 2 patients (1.65% [mean 0.0165; 95% CI 0.002-0.058]).


CONCLUSIONS
In this study, the most common site of adenoma was the left inferior parathyroid gland. This information provides parathyroid surgeons with a starting point when imaging fails to localize the site of the adenoma, which allows for the possibility of minimally invasive surgery especially if used in conjunction with intraoperative parathyroid hormone.
Marzouki
Hani Z
HZ
Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, 3755 Chemin de la Cote-Ste-Catherine Road, Montreal, QC H3T 1E2.
Chavannes
Mallory
M
Tamilia
Michael
M
Hier
Michael P
MP
Black
Martin J
MJ
Levental
Mark
M
Payne
Richard J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016105:Parathyroidectomy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult