Gamma Probe-Guided Parathyroid Cancer Resection

Abstract

Minimally invasive radioguided parathyroidectomy using a small incision and intraoperative gamma probe has reduced the need for bilateral neck exploration in the surgery of primary hyperparathyroidism. Although the role of radioguided surgery in parathyroid adenomas is well documented, its use in parathyroid carcinoma is not established. Surgery is the only effective treatment of the parathyroid carcinoma. Reoperations are often required for recurrences. We present 2 patients with parathyroid carcinoma one of whom required 4 reoperations for disease recurrence. Preoperative Tc-99m MIBI scans are useful in defining the location of the parathyroid lesions in both patients. On the day of the surgery Tc-99m MIBI was given and the neck explorations were guided by a gamma probe, which enabled the complete resection of the lesion and prevented more radical surgery.