Radiofrequency ablation of parathyroid adenomas causing primary hyperparathyroidism: A report of 27 patients.

PURPOSE: To study treatment outcome of parathyroid adenomas using ultrasound-guided radiofrequency ablation. METHODS: Twenty-seven patients with a single adenoma of the parathyroid gland were included in the study. Using color Doppler ultrasonography, the lesion and its characteristics were determined, and dextrose was injected to dissect the gland from the surrounding structures. The ablation process was done with 6-12 watts of power. RESULTS: No complications were seen in any of the subjects. A significant reduction was seen in serum parathyroid hormone (PTH) and calcium levels after treatment. PTH levels showed a median decrease of 13.8%, and a median decrease of 8.2% was seen in serum calcium levels (p < 0.001). Phosphorus levels did not change significantly after treatment. In 1-month follow-up of patients, the lesion size had decreased considerably. In long-term follow-up, 11 of 20 patients having subsequent imaging had indistinguishable lesions. CONCLUSION: Our results showed that RFA of parathyroid adenomas caused a significant reduction in biomedical indicators of disease and resulted in a significant reduction or disappearance of the lesion in the majority of the patients while having no considerable complications.

Radiofrequency Ablation of Parathyroid Adenoma: Results of a Retrospective Analysis of 60 Patients.

PURPOSE: To present the effectiveness and safety of radiofrequency ablation (RFA) in parathyroid adenoma (PTA). MATERIALS AND METHODS: In this retrospective study, 60 patients with a single PTA were evaluated for changes in biochemical and ultrasonographic features up to 6 months after RFA of the lesion. Adenomas were ablated with an alternative technique so called "Nik jet dissection" which incorporates full hydrodissection and polar artery coagulation. Complications as well as the variations in biochemical data and nodule volumes were analyzed between baseline measurements and at each follow-up interval data (first day, 1, 3, and 6 months after ablation) were analyzed. RESULTS: A significant reduction in serum intact parathyroid hormone and calcium levels was observed 6 months after ablation, with a mean difference of - 83.4 ± 104.1 pg/mL, p < 0.001, and - 0.29 ± 0.22 mmol/L, p < 0.001, respectively. Serum phosphorus levels increased significantly with a mean difference of 0.09 ± 0.19 mmol/L, p = 0.040 at the end of the follow up. We observed a significant volume reduction rate of parathyroid adenomas with 89 ± 20.8 percent, p < 0.001. Also, 51% of adenomas disappeared at the end of the follow up. In this study, two cases of hematoma and one case of transient hoarseness (grade 1 of the CIRSE classification) were encountered. CONCLUSION: Our study showed that RFA with the alternative technique, called "Nik jet dissection" is a safe and effective modality in management of PTA. Therefore, we suggest expanding the indications for RFA in PTA management, especially when surgery is not feasible. LEVEL OF EVIDENCE: Level 3, Local non-random sample.

Hydrodissection: A Novel Approach for Safe Core Needle Biopsy of Small High-Risk Subcapsular Thyroid Nodules.

PURPOSE: To evaluate the safety and effectiveness of core needle biopsy (CNB) under the assistance of hydrodissection (HDS). MATERIALS AND METHODS: Of 2325 patients requiring biopsy of thyroid lesions, 21 high-risk patients with subcapsular nodules smaller than 10 mm were recruited into this study. All patients underwent HDS with 0.9% saline solution followed by ultrasound (US)-guided CNB with an 18-gauge semi-automated biopsy needle. The separation success rate (SSR) of the HDS, technical success rate (TSR) of CNB, histopathologic success rate (HSR), and complications were assessed. RESULTS: Both the SSR of HDS and TSR of CNB were 100% (21/21). The HSR of the thyroid nodules was 85.7% (18/21). No major complications were recorded. CONCLUSION: HDS before CNB can successfully lead to safe biopsy of small subcapsular thyroid nodules. LEVEL OF EVIDENCE: Level 4, Case Series.

Hydatidosis of the pelvic cavity: a big masquerade.

We report and discuss a case of primary hydatidosis of the pelvic cavity in a woman who presented with severe weight loss and abdominal pain. This unusual presentation was initially considered as a tumor process until surgical exploration and microscopic studies confirmed the diagnosis. The gynecologists should be aware of possibility of primary hydatid cyst of the pelvic cavity and should be considered in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic.