Incidentalomas during imaging for primaryhyperparathyroidism—incidence andclinical outcomes
2015
Background: Imaging for pre-operative localisation of parathyroid glands in primary hyperparathyroidism is now
routine. This has led to the detection of incidental lesions (incidentalomas) in other organs, the nature of which is
not well characterised.
The aim of this study was to determine the incidence, characteristics and outcomes in patients who had incidental
findings on parathyroid imaging.
Methods: Records of patients who underwent imaging for primary hyperparathyroidism over 2 years were reviewed
to identify incidental lesions detected on parathyroid imaging. Patients with persistent or renal hyperparathyroidism
were excluded. Details on the management of detected incidentalomas were obtained from patient records.
Results: Incidentalomas were identified in 17 of 170 patients (10 %) undergoing parathyroid imaging. Incidentalomas
included thyroid (n = 11), breast (n = 3), lateral compartment of the neck (n = 1), lung (n = 1) and clavicle (n = 1). However,
no disease of clinical significance needing treatment was detected on further investigation.
Conclusions: Although a significant proportion of patients undergoing parathyroid imaging had incidental lesions
detected, these seem to be of little clinical significance. The morbidity and cost of further interventions on these
incidentalomas need to be weighed against the benefits of routine imaging in improving outcomes of first-time
surgery in patients with primary hyperparathyroidism.
Keywords: Parathyroid gland, Primary hyperparathyroidism, Imaging, Incidentalomas
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