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Case Report
Enrique Casanueva-Perez
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran: Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8106-4051
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Background
Total parathyroidectomy with autotransplantation of parathyroid tissue to the forearm is one of the treatment modalities for primary hyperparathyroidism (PHPT) in multiple endocrine neoplasia type 1 (MEN 1). Recurrence rate with this approach has been documented in up to 35% of patients. The amount of tissue to be preserved during autograft debulking has not been well established.
Methods
Preoperative assessment begins with biochemical confirmation of recurrent PHPT. Anatomic and functional imaging must be obtained. Intraoperative PTH monitoring is used to evaluate adequate amount of parathyroid tissue to be debulk pursuing more than 50% of PTH drop.
Results
One patient with recurrent MEN1 related PHPT successfully underwent autograft debulking using the Miami criterion to assess adequate resection. The postoperative course was uneventful and on follow up the patient did not develop hypoparathyroidism.
Conclusion
The use of Miami criterion during autograft debulking reoperations in the setting of MEN-1 is a feasible tool to achieve remission of primary hyperparathyroidism.
Keywords
primary hyperparathyroidism, Miami criterion, multiple endocrine neoplasia type 1, autograft, recurrent
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Posted 07 Jun, 2021
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This preprint is under consideration at SN Comprehensive Clinical Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case Report
Enrique Casanueva-Perez
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran: Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8106-4051
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 07 Jun, 2021
No community comments so far
Reviewers invited
Invitations sent on 03 Jun, 2021
First submitted
On 13 Apr, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Endocrinology & Metabolism
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Total parathyroidectomy with autotransplantation of parathyroid tissue to the forearm is one of the treatment modalities for primary hyperparathyroidism (PHPT) in multiple endocrine neoplasia type 1 (MEN 1). Recurrence rate with this approach has been documented in up to 35% of patients. The amount of tissue to be preserved during autograft debulking has not been well established.
Methods
Preoperative assessment begins with biochemical confirmation of recurrent PHPT. Anatomic and functional imaging must be obtained. Intraoperative PTH monitoring is used to evaluate adequate amount of parathyroid tissue to be debulk pursuing more than 50% of PTH drop.
Results
One patient with recurrent MEN1 related PHPT successfully underwent autograft debulking using the Miami criterion to assess adequate resection. The postoperative course was uneventful and on follow up the patient did not develop hypoparathyroidism.
Conclusion
The use of Miami criterion during autograft debulking reoperations in the setting of MEN-1 is a feasible tool to achieve remission of primary hyperparathyroidism.
Figure 1
Figure 2
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