Journal Article

The Role of Prophylactic Parathyroidectomy during Thyroidectomy for MTC in Patients with MEN2A Syndrome

Romanidis, Konstantinos, Kavazis, Christos, Pitiakoudis, Michail, Sapalidis, Konstantinos, Laskou, Styliani, Kesisoglou, Isaak

2023

Overview

I4enb: ()itpc;i.c;tii'ii> b itpi><|)ii;taK'in>tccKi>ii itapa™pci>ii;i,')K'ii>Mnn itpn xnpypnrtccKoM actcnnn Mcayaapnoro TtipeotiflHoro paKa (MTP) nprt crtHHpoMe Miio/Kcc'i ticmion shhokpmhhom HeonnaartM Tuna Ila (MEN2A) nyTCM oóaopa TiMTepaTypbi. MaiepuaJlbl U MeiOflbi: Houck npoBOHrracM b óaae naHHMX PubMed c McnoTibaoBaHMeM TepMMHOB „napaTMpeoMHOKTOMJWi\" m „mcayaaapinan\" b tnvuix „I laaiiannc\" n „PetJjepaT\", a TaioKe b base namnax Google Scholar. Caaabn 6e3 ccmxok na ca paacrnn ncncnna napaniMTOBMHHOM xeneabi b ochobhom HCKnioHanHCb. Resyjlbiaibi: HeTbipnaniiaib eraren óbuirt paccMorpenbi KaK MMeronine orHomenne k naHHOMy rtcoieHOBaHwo OTHOCHreabHO peKOMeHHaiiHH no Tienenjík> napaniHTOBHHHbixiKenea bo BpeMM npotjiHnaKTHHecKOH THpeoHHOKioMHH y naiirtenroB c MTP npn cnnnpoMe MEN2A. Tpn H3 hhx MMenn ry tace mjim ÓJinsKyio pejib, nro m ñama paóora, m caMbiü nocnejiHMM 0630p aHreparypbi ne noHTBepHHn OHHOsnanno hh o^ny H3 HByx crpareritM ynpaBTienmi. CcbuiKM na nenenne napaniHTOBHHHOH aceneabi óbinn naHHenbi b ocraabnbix crarbax, no hx ncniao ne óbino onpcacncnnc cooiBercTByionieM crparermi nenenna. BoabninncrBO aBropoB noajlcp/KiniaioT coxpanenne MaKpocKonnnecKH nopMaabnbix napaniHTOBHHHbix acenea, b to BpeMM KaK ohho HccneflOBanHe or^aer npennonrenite pymHnoH rorajibnoií napaTHpeoHHOKTOMHH m ayiorpaHcnnaHiaiiMH. SaK/HOMenue: Xot;i sotiototo crannapra ne cymecTByer, crparermi coxpanenmi MaKpocKonnnecKH nopMaabnbix napaniHTOBHHHbix acenea c noMonibio pyrunnbix Tiaóoparopnbix nccncaoiiannn m XHpyprnnecKoro nccnc/toiianna riniepnapaTJipeoaa bo Bpcvui THpeoHHoktomhh KaaceTCM óeaonacnoH m stjxjjeKTHBHOH crpareriteM. Aim: To define the role of prophylactic parathyroidectomy in the surgical treatment of medullary thyroid carcinoma (MTC) in multiple endocrine neoplasia type Ila (MEN2A) syndrome through a literature review. Materials and methods: The database of PubMed was searched using the terms \"parathyroidectomy\" and \"medullary\" in the fields \"Title\" and \"Abstract\", as well as the Google Scholar database. Articles without references to parathyroid management strategies were mainly excluded. Results: Fourteen articles were reviewed as relevant to this study regarding recommendations for the management of parathyroids during prophylactic thyroidectomy in patients with MTC in MEN2A syndrome. Three of them had the same or similar purpose to our work, and the most recent literature review did not clearly support either one of the two management strategies. References to parathyroid management were found in the rest of the articles, but their purpose was not to determine the appropriate management strategy. The majority of the authors support the preservation of macroscopically normal parathyroid glands, while one study favored routine total parathyroidectomy and autografting. Conclusions: Although there does not seem to be a gold standard, the strategy of preserving macroscopically normal parathyroid glands with routine lab testing and surgical exploration for hyperparathyroidism during thyroidectomy seems to be a safe and effective strategy.

• Publisher: MEDICAL UNIVERSITY- PLOVDIV
• Subject: Asymptomatic / Genetic testing / Literature reviews / Lymphatic system / Mutation / Neuroendocrine tumors / Patients / Thyroid cancer / Thyroidectomy