Parathyroid Adenoma No Surgery 101: Radiofrequency Ablation is New Alternative to Parathyroid Surgery.
Parathyroid scan images before radiofrequency ablation show increased uptake of the radionuclide in the middle right lobe of the thyroid gland and after RF below.
- Are you a candidate?
- 2 cases presented show how simple and easy RF treatment can be for patients.
- Inferior location of the adenoma is the best for parathyroid RF.
- The inserted needle only needs a few minutes (12 -30 minutes) and at low watts( 5 watts) to ablate the adenoma as seen in this case report.
- The area around the parathyroid is belted with saline to protect vital structures near the adenoma.
- The polar artery to the adenoma is ablated as well.
- Come to see me to determine if your parathyroid adenoma can be safely treated without surgery in a short parathyroid RF treatment in my office.
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Featured image is an inferior parathyroid adenoma with visible polar artery.
Percutaneous sonography-guided radiofrequency ablation in the management of parathyroid adenoma
Singapore Med J 2013; 54(7):
Shuang-ying Xu1, et al
Parathyroid adenoma is a major cause of primary hyperparathyroidism. Treatment usually involves the surgical removal of one or more parathyroid glands. However, specific localising techniques have boosted the development of nonsurgical, minimally invasive procedures, such as percutaneous radiofrequency ablation (RFA) under ultrasonographic guidance, which are gaining popularity as a method of treatment.
This paper reports two male patients who presented with hypercalcaemia (highest serum calcium level 4.56 mmol/L and 4.57 mmol/L, respectively) and hyperparathyroidism (highest serum parathyroid hormone [PTH] level 772 ng/L and > 1,900 ng/L, respectively) due to solitary parathyroid adenoma.
RFA was done after local anaesthesia was administered, an isolation belt around the inferior right of the parathyroid gland was created using normal saline to protect the gland from unnecessary injury. The radiofrequency needle was inserted into the center of the parathyroid adenomatous tissue, and an ablation power of 5 W was applied for 12 min.
Four days after percutaneous RFA, the serum calcium levels in both patients decreased and PTH levels showed a significant decreasing trend. Both patients recovered well with normal levels of calcium and improvement of symptoms.
Thus, we conclude that RFA may be a safe and effective therapeutic option in the treatment of parathyroid adenoma.