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QJM Advance Access originally published online on May 22, 2008
QJM 2008 101(8):657-662; doi:10.1093/qjmed/hcn062
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Modified percutaneous ethanol injection of parathyroid adenoma in primary hyperparathyroidism

C. Cappelli, G. Pelizzari, I. Pirola, E. Gandossi, E. De Martino, A. Delbarba, B. Agosti, E. Agabiti Rosei and M. Castellano

From the Department of Medical and Surgical Sciences, Internal Medicine and Endocrinology Unit, University of Brescia, Brescia, Italy

Address correspondence to C. Cappelli, MD, Department of Medical and Surgical Sciences, Internal Medicine and Endocrinology Unit, University of Brescia, c/o 2^ Medicina Spedali Civili di Brescia, Piazzale Spedali Civili n°1, 25100 Brescia, Italy. email: cappelli{at}med.unibs.it

Received 16 December 2007 and in revised form 16 April 2008


  Abstract

Surgery is the treatment of choice for symptomatic primary hyperparathyroidism; unlikely few patients do not meet established surgical criteria or have comorbid conditions that prohibit surgery.

In these subjects, medical therapy alone offers little hope for a sustained long normocalcemic period. However percutaneous ethanol injection (PEI) may represent an alternative therapeutic procedure. It is currently in use for the treatment of secondary or tertiary hyperparathyroidism, however, few studies or case reports suggest it for the treatment of primary hyperparathyroidism. Moreover, little information is available about the long-term follow-up, where incomplete necrosis or the spreading of ethanol in the surrounding tissues is often reported. We believe that many of the side effects could be correlated to procedure itself. Taking these experiences into account, we have reasoned that in order to limit these side effects, we had to modify the standard PEI procedure.

We reported this preliminary experience describing our modified PEI procedure.


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