Background: In patients with primary hyperparathyroidism (pHPT) the therapeutical choice is surgery. In patients with high surgical and anesthetic risks, ultrasound-guided laser ablation (LTA) of parathyroid adenoma has been reported to reduce parathyroid hormone (PTH) hypersecretion without relevant side effects. No data are available from patients followed for >6 months. We report our 3-year follow-up experience with LTA in 3 patients affected by pHPT due to a parathyroid tumor. Methods: LTA was performed under color-Doppler ultrasound guidance with a continuous pulse at 2 W (total treatment duration: 300 s in each session; total energy: 1,200 J in two sessions). Results: In the first patient who refused to undergo the second LTA session, calcium, PTH levels and parathyroid lesion volume showed a slight reduction, returning to baseline values in a month. In the second patient, no modification of parathyroid lesion was obtained even if calcium levels temporarily normalized. In the third patient, LTA led to normalization of calcium and PTH levels and to a 99% reduction of parathyroid volume. Conclusion: After LTA procedures the long-term disease remission of pHPT is achievable in a minority of patients. Data from larger samples are needed to verify the usefulness of this procedure.

Keywords:
Parathyroid tumors, Laser thermal ablation, Primary hyperparathyroidism
1.
Strewler GJ: Medical approaches to primary hyperparathyroidism. Endocrinol Metab Clin North Am 2000;29:523–529.
2.
Bennedbæk FN, Karstrup S, Hegedus L: Percutaneous ethanol injection therapy in the treatment of thyroid and parathyroid disease. Eur J Endocrinol 1997;136:240–250.
3.
Bennedbæk FN, Karstrup S, Hegedus L: Ultrasound-guided laser ablation of a parathyroid adenoma. Br J Radiol 2001;74:905–907.
4.
Papini E, Bizzarri G, Guglielmi R, Brufani C, Valcavi R, Frasoldati A, Palma E, Pacella MC: Ultrasound-guided laser thermal ablation of hyperfunctioning parathyroid adenomas. Feasibility study. 87th Annual Meeting of the Endocrine Society, New Orleans 2004, OR22–1.
5.
Bilezikian JP, Potts JT Jr, Fuleihan Gel H, Kleerekoper M, Neer R, Peacock M, Rastad J, Silverberg SJ, Udelsman R, Wells SA: Summary statement from workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol Metab 2002;87:5353–5361.
6.
Peacock M, Bilezikian JP, Klassen PS, Guo MD, Turner SA, Shoback D: Cinacalcet hydrochloride maintains long-term normocalcemia in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 2005;90:135–141.
7.
Khan AA, Bilezikian JP, Kung AW, Ahmed MM, Dubois SJ, Ho AY, et al: Alendronate in primary hyperparathyroidism: a double-blind, randomized, placebo-controlled trial. J Clin Endocrinol Metab 2004;89:3319–3325.
© 2006 S. Karger AG, Basel
2006
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