The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism

Surgery. 2008 Dec;144(6):878-83; discussion 883-4. doi: 10.1016/j.surg.2008.08.031.


Background: Operation for multiple endocrine neoplasia (MEN)1-related hyperparathyroidism (HPT) includes a neck exploration with resection of 3.5 or 4 parathyroid glands and transcervical thymectomy (TCT). We reviewed our experience with initial operation for primary HPT to determine the outcome and utility of routine TCT.

Methods: All patients with MEN1 who underwent initial neck exploration from 1993 to 2007 under an institutional review board-approved protocol were reviewed.

Results: We identified 66 patients with initial operation for HPT in MEN1. In 34 patients, 4 glands were found; in 32 patients, <4 glands were found. In 2 of the 34 (6%) and 17 of the 32 (53%), intrathymic parathyroid tissue was found on permanent pathology. No thymic carcinoid tissue was found in any specimen.

Conclusion: These data highlight the importance of performing TCT when <4 entopic parathyroid glands are found at first operation.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Female
  • Humans
  • Hyperparathyroidism / etiology
  • Hyperparathyroidism / surgery*
  • Male
  • Multiple Endocrine Neoplasia Type 1 / complications*
  • Neck
  • Thymectomy / methods*