title: Incidentalomas during imaging for primary hyperparathyroidism--incidence and clinical outcomes.
abstract: BACKGROUND
  Imaging for pre-operative localisation of parathyroid glands in primary hyperparathyroidism is now routine. This has led to the detection of incidental lesions (incidentalomas) in other organs, the nature of which is not well characterised. The aim of this study was to determine the incidence, characteristics and outcomes in patients who had incidental findings on parathyroid imaging.
  
  
  METHODS
  Records of patients who underwent imaging for primary hyperparathyroidism over 2 years were reviewed to identify incidental lesions detected on parathyroid imaging. Patients with persistent or renal hyperparathyroidism were excluded. Details on the management of detected incidentalomas were obtained from patient records.
  
  
  RESULTS
  Incidentalomas were identified in 17 of 170 patients (10%) undergoing parathyroid imaging. Incidentalomas included thyroid (n = 11), breast (n = 3), lateral compartment of the neck (n = 1), lung (n = 1) and clavicle (n = 1). However, no disease of clinical significance needing treatment was detected on further investigation.
  
  
  CONCLUSIONS
  Although a significant proportion of patients undergoing parathyroid imaging had incidental lesions detected, these seem to be of little clinical significance. The morbidity and cost of further interventions on these incidentalomas need to be weighed against the benefits of routine imaging in improving outcomes of first-time surgery in patients with primary hyperparathyroidism.
authors.affiliation: Endocrine Surgery Unit, Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Pooja.Prasad@doctors.org.uk.|Academic Unit of Surgical Oncology, Department of Oncology, School of Medicine and Biomedical Sciences, The University of Sheffield, Sheffield, S10 2RX, UK. Pooja.Prasad@doctors.org.uk.
authors.forename: P
authors.initials: P
authors.lastname: Prasad
authors.affiliation: Department of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: C
authors.initials: C
authors.lastname: Clout
authors.affiliation: Department of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: E
authors.initials: E
authors.lastname: Lorenz
authors.affiliation: Endocrine Surgery Unit, Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: B J
authors.initials: BJ
authors.lastname: Harrison
authors.affiliation: Endocrine Surgery Unit, Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.|Academic Unit of Surgical Oncology, Department of Oncology, School of Medicine and Biomedical Sciences, The University of Sheffield, Sheffield, S10 2RX, UK.
authors.forename: S P
authors.initials: SP
authors.lastname: Balasubramanian
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies