Endocrine Abstracts

Background: The curative therapy of primary hyperparathyroidism (pHPT) is surgery. Data about ultrasound-guided laser ablation (LA) of parathyroid tumor are limited, however it could be a solution for patients with high surgery or anesthetic risk. We report our experience on LA of parathyroid tumors in 11 patients with pHPT with high surgery or anesthetic risk.

Methods: LA was performed under ultrasound guidance with an output power of 3W. Total energy and time of ablation was set individually, to make the ablation zone (monitored with real-time ultrasound and power Doppler) cover the entire parathyroid tumor.

Results: At baseline, serum calcium and iPTH concentrations were above normal range in all patients (2.62–3.34 mmol/l and 66.58–875 pg/ml, respectively). At day 1 after LA serum calcium normalized in 7/11, was under the normal range in 3/11 treated. Serum iPTH was low in 6, normal in 2 and elevated in 3 subjects (2 of them with hypocalcemia). At 3 months after ablation serum calcium and iPTH normalizedin 10/11. In one patient with large parathyroid tumor (3 ml) only partial improvement (decrease of calcium and iPTH concentrations) was achieved. Vocal cord palsy was observed in one of the subjects treated.

Conclusion: LA may be a valuable alternative treatment for patients with primary hyperparathyroidism and high surgery or anesthetic risk.