Ultrasound-guided microwave ablation in the treatment of recurrent primary hyperparathyroidism in a patient with MEN1: a case report

Front Endocrinol (Lausanne). 2023 Sep 19:14:1175377. doi: 10.3389/fendo.2023.1175377. eCollection 2023.

Abstract

Background: Multiple endocrine neoplasia type 1 (MEN1) is an inherited endocrine syndrome caused by the mutation in the tumor suppressor gene MEN1. The recurrence rate of primary hyperparathyroidism (PHPT) in patients with MEN1 after parathyroidectomy remains high, and the management of recurrent hyperparathyroidism is still challenging.

Case presentation: We reported a 44-year-old woman with MEN1 combined with PHPT who was diagnosed through genetic screening of the patient and her family members. After parathyroidectomy to remove one parathyroid gland, the patient suffered from persistent high levels of serum calcium and parathyroid hormone, which returned to normal at up to 8 months after ultrasound-guided microwave ablation (MWA) for bilateral parathyroid glands, suggesting an acceptable short-term prognosis.

Conclusion: Ultrasound-guided MWA for parathyroid nodules may be an effective therapeutic strategy for recurrent PHPT in MEN1 patients.

Keywords: case report; microwave ablation; multiple endocrine neoplasia; primary hyperparathyroidism; recurrence.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Hyperparathyroidism, Primary* / complications
  • Hyperparathyroidism, Primary* / diagnostic imaging
  • Hyperparathyroidism, Primary* / surgery
  • Microwaves / therapeutic use
  • Multiple Endocrine Neoplasia Type 1* / complications
  • Multiple Endocrine Neoplasia Type 1* / genetics
  • Multiple Endocrine Neoplasia Type 1* / surgery
  • Parathyroid Glands / diagnostic imaging
  • Parathyroid Glands / pathology
  • Parathyroid Glands / surgery
  • Ultrasonography, Interventional

Grants and funding

Design and data collection were supported by the grant supports of Medical Scientific Research Foundation of Jiangsu Province of China (Surface project) (M2020102), Jiangsu Provincial Key Research and Development Program (BE2020726), and Thyroid Research Project of Young and Middle-Aged Doctors of China International Medical Exchange Foundation (BQE-JZX-202115).