question-icon

Suggest treatment for adenomas on parathyroid glands

default
Posted on Mon, 18 May 2015
Question: My wife has 3 adenomas on three parathyroid glands. She cannot have surgery due to anatomical restrictions. I am trying to find a surgeon who does "percutaneous alcohol ablation". Injecting alcohol into the gland etc. She is 72 and her bones have been de-mineralized by excessive PTH. Can you email me any info. as to where I could take her for this treatment. Thanks XXXXXXX XXXXXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (8 hours later)
Brief Answer:
Laser ablation

Detailed Answer:
Good day,
Noted your concern. Involvement of 3 glands is suspicious of MEN syndrome or pparathyroid hyperplasia. There is always a future chance of adenoma formation in the fourth gland. Hence most surgeons prefer to take out all 4 glands and then deposit a small portion of gland under the skin. Some people take out 3.5 gland and leave half gland at situ. While surgery is the best option, i understand that she can not be intubated. Surgery under local anaesthesia is possible, but should be done in highly experienced centers. Percutaneous alcohol ablation has high failure rate.

LASER treatment and radio frequency ablation are newer techniques for thyroid and parathyroid adenomas which involves no surgery. I do not think it is widely used in USA. But this commonly used in Italy. You could mail the following endocrinologists in Italy and enquire about getting alcohol ablation or laser treatment. This doesnt require general anesthesia.

You may email,

Dr. Paolo Vitti YYYY@YYYY ,
Dr. Rosella Elisei YYYY@YYYY
Dr XXXXXXX Valcavi YYYY@YYYY


By the way, has she had a nuclear scan ( Technicium Parathyroid SESTAMIBI) to localize the parathyroid adenomas? A proper localization is very importnant prior to any procedure.

Regards
Binu



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for adenomas on parathyroid glands

Brief Answer: Laser ablation Detailed Answer: Good day, Noted your concern. Involvement of 3 glands is suspicious of MEN syndrome or pparathyroid hyperplasia. There is always a future chance of adenoma formation in the fourth gland. Hence most surgeons prefer to take out all 4 glands and then deposit a small portion of gland under the skin. Some people take out 3.5 gland and leave half gland at situ. While surgery is the best option, i understand that she can not be intubated. Surgery under local anaesthesia is possible, but should be done in highly experienced centers. Percutaneous alcohol ablation has high failure rate. LASER treatment and radio frequency ablation are newer techniques for thyroid and parathyroid adenomas which involves no surgery. I do not think it is widely used in USA. But this commonly used in Italy. You could mail the following endocrinologists in Italy and enquire about getting alcohol ablation or laser treatment. This doesnt require general anesthesia. You may email, Dr. Paolo Vitti YYYY@YYYY , Dr. Rosella Elisei YYYY@YYYY Dr XXXXXXX Valcavi YYYY@YYYY By the way, has she had a nuclear scan ( Technicium Parathyroid SESTAMIBI) to localize the parathyroid adenomas? A proper localization is very importnant prior to any procedure. Regards Binu