Tratamento cirúrgico de hiperparatireoidismo primário associado a Neoplasia Endócrina Múltipla tipo 1.

Abstract

Multiple Endocrine Neoplasms are rare genetic syndromes that predispose the emergence of multiple organ tumors on endocrine tissue. The most common initial manifestation of the disease is primary hyperparathyroidism, which is present in over 90% of affected individuals. The literature mentions subtotal parathyroidectomy and total parathyroidectomy with heterotopic autoimplant as the main surgical treatment modalities, although both methods may present hypoparathyroidism as a postoperative complication. On the other hand, less aggressive techniques, such as unilateral clearence, may be advantageous because, besides determining a lower incidence of postoperative hypoparathyroidism, a possible re-approach would be performed in an untouched surgical bed in cases of disease recurrence, a relatively frequent situation in this patients treated surgically, regardless of the method. Thus, the aim of the present study is to characterize the profile of patients surgically treated for this morbidity at the Walter Cantídio University Hospital of the Federal University of Ceará. This study is an analytical, observational, cross-sectional, retrospective study, with documentary research and quantitative analysis of the collected data. We analyzed 10 medical records of patients undergoing parathyroidectomy for Multiple Endocrine Neoplasia type 1 between january 2018 and september 2019, with a mean age of 49.67 years, of both sexes, who had mainly osteopenia. Pre and postoperative laboratory tests were compared between the seven individuals who underwent unilateral clearance and the three who underwent bilateral cervical exploration. It was found that patients undergoing both procedures had similar serum laboratory tests. It was observed that the variation of laboratory tests after surgery did not depend on the surgery applied. Both surgical procedures had similar short-term results, but studies with a larger number of patients and longer-term follow-up are needed.