WHAT IS THE INCIDENCE OF CAP IN PARATHYROID ADENOMAS? chorange2404@gmail.com

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WHAT IS THE INCIDENCE OF CAP IN PARATHYROID ADENOMAS?

7

Greece

Oral or Poster

Autofluorescence in parathyroid tissue is produced by an endogenous fluorophore. Even though all adenomas showed a heterogeneous pattern of autofluorescence, some display a clear, well-defined bright region within the gland named “cap” corresponding to the normal remnant. This study aims to determine the characteristics of patients with parathyroid adenoma who have a “cap” versus those without a “cap”.

It is a retrospective study of a prospectively formed database, including all patients operated on for a single adenoma, over the five-year period during which we employed Fluobeam LX. 494 single adenoma patients were divided, based on the presence of cap in the pathology report, into “cap” and “non-cap” groups (335 vs 159 patients). The epidemiologic, biochemical, and pathology characteristics of both groups were recorded and analyzed.

There is no statistically significant difference between the groups existed concerning demographic and biochemical characteristics (pre- and post-operative parathormone, calcium, and phosphorus levels). In pathology, the adenomas of the “cap” group were significantly heavier than those of the “non-cap” (1.741[2.789] vs 1.345 [1.238] (p=0.001)), while there was no difference in the maximal diameter. The “non-cap” adenomas were predominantly left-sided (p=0.01). CAPTHUS score was similar for both groups, while intra-operative fluorescence presented “cap sign” in 91.3% for the “cap” group vs 3.1% for the “non-cap”.

Single adenomas present a remnant of normal tissue in 68% of cases. The patients in the “cap” group present fluorescence of the remnant intra-operatively. The “non-cap” group has a higher probability of having the adenoma located on the left side.