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open access

Vol 69, No 2 (2018)
Original paper
Submitted: 2017-07-25
Accepted: 2018-01-08
Published online: 2018-03-29
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A follow-up study of patients with MEN syndromes — five case reports

Grzegorz Buła1, Witold Truchanowski1, Henryk Koziołek1, Joanna Polczyk1, Paweł Ziora1, Jacek Gawrychowski1
DOI: 10.5603/EP.2018.0020
·
Pubmed: 29952424
·
Endokrynol Pol 2018;69(2):163-167.
Affiliations
  1. Department of General and Endocrine Surgery School of Medicine with the Division of Dentistry in Zabrze Medical University of Silesia, Katowice, Poland, Batorego 15, 41-902 Bytom, Poland

open access

Vol 69, No 2 (2018)
Original Paper
Submitted: 2017-07-25
Accepted: 2018-01-08
Published online: 2018-03-29

Abstract

THE AIM OF THE STUDY: Evaluation of the results of surgical treatment in patients with hyperparathyroidism related to MEN syndrome MATERIALS AND METHODS: The group of three women and two men aged between 17 and 72 years ( av. 38.6) with MEN- related hyperparathyroidism within 419 patients were operated between 2010-2016. MEN1 syndrome was diagnosed in four patients and MEN2 only once. Pre- and postoperative results of PTH levels and serum calcium values were compared. RESULTS: The mean preoperative serum PTH level was 215,56 pg/ml, whereas calcium concentration was 1.40 mmol/l. Three Patients with MEN1 syndrome had three and two thirds of parathyroid gland taken, and one had a single parathyroid gland excised with biopsy of the rest glands performed. A patient with MEN2 syndrome had one parathyroid gland excised. Postoperatively, we reported decreased secretion of both PTH (a mean serum PTH concentration 6.72 pg/ml), and serum calcium concentration 1.11 mmol/l. One patient (25%) with MEN 1 developed recurrent hyperparathyroidism after five years from the surgery. The patient was reoperated. The rest of the parathyroid gland was removed with an implantation into separated muscle pockets in the anterior forearm muscles. CONCLUSIONS: 1. MEN syndrome is a rare cause of primary hyperparathyroidism. 2. Subtotal parathyroidectomy helps to bring back a normal calcium metabolism. 3. Recurrence of hyperparathyroidism in patients with MEN syndrome requires total parathyroidectomy with an autotransplantation into the anterior forearm muscles.

Abstract

THE AIM OF THE STUDY: Evaluation of the results of surgical treatment in patients with hyperparathyroidism related to MEN syndrome MATERIALS AND METHODS: The group of three women and two men aged between 17 and 72 years ( av. 38.6) with MEN- related hyperparathyroidism within 419 patients were operated between 2010-2016. MEN1 syndrome was diagnosed in four patients and MEN2 only once. Pre- and postoperative results of PTH levels and serum calcium values were compared. RESULTS: The mean preoperative serum PTH level was 215,56 pg/ml, whereas calcium concentration was 1.40 mmol/l. Three Patients with MEN1 syndrome had three and two thirds of parathyroid gland taken, and one had a single parathyroid gland excised with biopsy of the rest glands performed. A patient with MEN2 syndrome had one parathyroid gland excised. Postoperatively, we reported decreased secretion of both PTH (a mean serum PTH concentration 6.72 pg/ml), and serum calcium concentration 1.11 mmol/l. One patient (25%) with MEN 1 developed recurrent hyperparathyroidism after five years from the surgery. The patient was reoperated. The rest of the parathyroid gland was removed with an implantation into separated muscle pockets in the anterior forearm muscles. CONCLUSIONS: 1. MEN syndrome is a rare cause of primary hyperparathyroidism. 2. Subtotal parathyroidectomy helps to bring back a normal calcium metabolism. 3. Recurrence of hyperparathyroidism in patients with MEN syndrome requires total parathyroidectomy with an autotransplantation into the anterior forearm muscles.

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Keywords

multiple endocrine neoplasia, parathyroid neoplasms, hyperparathyroidism, parathyroid glands, parathyroidectomy, thyroid gland, calcium metabolism

About this article
Title

A follow-up study of patients with MEN syndromes — five case reports

Journal

Endokrynologia Polska

Issue

Vol 69, No 2 (2018)

Article type

Original paper

Pages

163-167

Published online

2018-03-29

Page views

2231

Article views/downloads

1066

DOI

10.5603/EP.2018.0020

Pubmed

29952424

Bibliographic record

Endokrynol Pol 2018;69(2):163-167.

Keywords

multiple endocrine neoplasia
parathyroid neoplasms
hyperparathyroidism
parathyroid glands
parathyroidectomy
thyroid gland
calcium metabolism

Authors

Grzegorz Buła
Witold Truchanowski
Henryk Koziołek
Joanna Polczyk
Paweł Ziora
Jacek Gawrychowski

References (23)
  1. Duan K, Gomez Hernandez K, Mete O. Clinicopathological correlates of hyperparathyroidism. J Clin Pathol. 2015; 68(10): 771–787.
    CrossRefPubMed
  2. Coutinho FL, Lourenço-Jr DM, Toledo RA, et al. Post-surgical follow-up of primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Clinics. 2012; 67(S1): 169–172.
    CrossRef
  3. Lacka K K. [Molecular aspects of the etiopathogenesis of the parathyroid gland diseases]. Endokrynol Pol. 2005; 56(3): 327–333.
    PubMed
  4. Lairmore TC, Govednik CM, Quinn CE, et al. A randomized, prospective trial of operative treatments for hyperparathyroidism in patients with multiple endocrine neoplasia type 1. Surgery. 2014; 156(6): 1326–34; discussion 1334.
    CrossRefPubMed
  5. Goudet P, Cougard P, Vergès B, et al. Hyperparathyroidism in multiple endocrine neoplasia type I: Surgical trends and results of a 256-patient series from groupe d’Etude des Néoplasies endocriniennes multiples study group. World Journal of Surgery. 2001; 25(7): 886–890.
    CrossRef
  6. Carling T, Udelsman R. Parathyroid surgery in familial hyperparathyroid disorders*. J Intern Med. 2005; 257(1): 27–37.
    CrossRefPubMed
  7. Tonelli F, Giudici F, Cavalli T, et al. Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy. Clinics. 2012; 67(S1): 155–160.
    CrossRef
  8. Yoshida S, Imai T, Kikumori T, et al. Long Term Parathyroid Function Following Total Parathyroidectomy with Autotransplantation in Adult Patients with MEN2A. Endocr J. 2009; 56(4): 545–551.
    CrossRefPubMed
  9. Shih RYW, Fackler S, Maturo S, et al. Parathyroid carcinoma in multiple endocrine neoplasia type 1 with a classic germline mutation. Endocr Pract. 2009; 15(6): 567–572.
    CrossRefPubMed
  10. Gawrychowski J, Kowalski G, Buła G. Kowalski G., Buła G.:Rak przytarczyc — diagnostyka i leczenie operacyjne. Doświadczenia 24-letnie. Pol Przeg Chir 2010; 82(2); . 2010; 82(2): 157–168.
  11. Hubbard JGH, Sebag F, Maweja S, et al. Primary hyperparathyroidism in MEN 1--how radical should surgery be? Langenbecks Arch Surg. 2002; 386(8): 553–557.
    CrossRefPubMed
  12. d’Alessandro A, Montenegro Fd, Brandão LG, et al. Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1. Rev Assoc Med Bras. 2012; 58(3): 323–327.
    CrossRefPubMed
  13. Nilubol N, Weinstein L, Simonds WF, et al. Preoperative localizing studies for initial parathyroidectomy in MEN1 syndrome: is there any benefit? World J Surg. 2012; 36(6): 1368–1374.
    CrossRefPubMed
  14. Gawrychowski J, Buła G. Imaging diagnostics for primary hyperparathyroidism. Endokrynol Pol. 2013; 64(5): 404–408.
    CrossRefPubMed
  15. Moley JF, Skinner M, Gillanders WE, et al. Management of the Parathyroid Glands During Preventive Thyroidectomy in Patients With Multiple Endocrine Neoplasia Type 2. Ann Surg. 2015; 262(4): 641–646.
    CrossRefPubMed
  16. Gertner ME, Kebebew E. Multiple endocrine neoplasia type 2. Curr Treat Options Oncol. 2004; 5(4): 315–325.
    PubMed
  17. Versnick M, Popadich A, Sidhu S, et al. Minimally invasive parathyroidectomy provides a conservative surgical option for multiple endocrine neoplasia type 1-primary hyperparathyroidism. Surgery. 2013; 154(1): 101–105.
    CrossRefPubMed
  18. Kobiela J, Łaski D, Stróżyk A, et al. From four-parathyroid gland exploration to a minimally invasive technique. Minimally invasive parathyroidectomy as a current approach in surgery for primary hyperparathyroidism. Endokrynol Pol. 2014; 65(3): 240–249.
    CrossRefPubMed
  19. Buła G, Niemiec A, Truchanowski W, et al. Śródoperacyjna ocena skuteczności leczenia chirurgicznego pierwotnej nadczynności przytarczyc. Pol Przeg Chir. 2008; 80(9): 860–866.
  20. Pieterman CRC, van Hulsteijn LT, den Heijer M, et al. DutchMEN1 Study Group. Primary hyperparathyroidism in MEN1 patients: a cohort study with longterm follow-up on preferred surgical procedure and the relation with genotype. Ann Surg. 2012; 255(6): 1171–1178.
    CrossRefPubMed
  21. Waldmann J, López CL, Langer P, et al. Surgery for multiple endocrine neoplasia type 1-associated primary hyperparathyroidism. Br J Surg. 2010; 97(10): 1528–1534.
    CrossRefPubMed
  22. Boltz MM, Zhang N, Zhao C, et al. Value of Prophylactic Cervical Thymectomy in Parathyroid Hyperplasia. Ann Surg Oncol. 2015; 22 Suppl 3: S662–S668.
    CrossRefPubMed
  23. Kraimps JL, Denizot A, Carnaille B, et al. Primary Hyperparathyroidism in Multiple Endocrine Neoplasia Type IIa: Retrospective French Multicentric Study. World J Surg. 1996; 20(7): 808–813.
    CrossRefPubMed

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