A nonsurgical alternative for the treatment of parathyroid adenoma

Ultrasound-guided percutaneous alcohol ablation

Abstract

Parathyroid adenoma is generally detected by the incidental finding of high blood levels of parathyroid hormone (PTH) and calcium, in association with decreased phosphorus. Diagnostic imaging is useful in order to establish the location of the parathyroid gland with regard to the thyroid parenchyma, and to visualize the lesion that is to be treated. The management of this disease has changed from complete extirpation of the parathyroid gland to minimally invasive procedures, such as ethanol ablation of the adenoma. In this review, the case is described of an elderly woman who is taken to the emergency department because of an alteration in consciousness. Her workup gave evidence of increased PTH and calcium levels. Imaging studies were suggestive of parathyroid adenoma. The patient was treated with percutaneous ethanol ablation, which was performed three times. The levels of hormones and calcium returned to normality, and the patient recovered her level of consciousness with no apparent sequels