Selective venous catheterisation and radioimmunoassay of parathyroid hormone in the diagnosis and localisation of parathyroid tumours.

Abstract

Abstract Selective venous catheterisation with parathyroid-hormone assay is a valuable procedure in the diagnosis and treatment of parathyroid tumours. Results are reported in fifteen patients, of whom thirteen had previously been explored for parathyroid tumours, including three with recurrent parathyroid carcinoma. Localisation was suggested in twelve and confirmed in ten of these patients. The procedure is time-consuming and not without risk. At University College Hospital, London, it is used in patients undergoing neck exploration for the first time only when there is great diagnostic difficulty—e.g., when other causes of hypercalcaemia are present as in two cases reported here. It is most helpful in patients with previous surgery in the neck, where it assists in localising parathyroid adenomas and in assessing the spread of parathyroid carcinomas. In these cases it may facilitate the decision to operate again, limit the area of search, and reduce the occurrence of postoperative complications.