99m-Technetium sestamibi localized solitary parathyroid adenoma as an indication for limited unilateral surgical exploration

Am J Surg. 1998 Nov;176(5):409-12. doi: 10.1016/s0002-9610(98)00244-x.


Background: Because of its successful localization of solitary adenomas, 99m-Technetium sestamibi (MIBI) may challenge the standard operation for primary hyperparathyroidism.

Methods: Thirty-five consecutive patients underwent preoperative MIBI localization to optimize a surgical approach. Single-site localization in 21 patients directed a limited unilateral neck exploration (UNE) with adenomectomy and ipsilateral gland biopsy. Fourteen patients who did not localize underwent bilateral neck exploration (BNE). Conversion to a bilateral operation was required in 1 UNE patient because no adenoma was found on that side.

Results: There were no significant differences in preoperative and postoperative serological markers between the two groups. However, the total operative time for UNE (49 +/- 21 minutes) was significantly less than for BNE (103 +/- 45 minutes; P <0.001).

Conclusions: Preoperative MIBI scan-directed limited unilateral neck operation may be used reliably for primary hyperparathyroidism due to a single adenoma, and thereby reduce operative time, extent of surgical dissection, and risk.

Publication types

  • Clinical Trial

MeSH terms

  • Adenoma / diagnostic imaging*
  • Adenoma / pathology
  • Adenoma / surgery*
  • Adult
  • Aged
  • Female
  • Humans
  • Hyperparathyroidism / etiology
  • Hyperparathyroidism / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Parathyroid Neoplasms / diagnostic imaging*
  • Parathyroid Neoplasms / pathology
  • Parathyroid Neoplasms / surgery*
  • Patient Selection
  • Preoperative Care
  • Radioimmunodetection*
  • Radiopharmaceuticals*
  • Technetium Tc 99m Sestamibi*
  • Time Factors


  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi