Microwave ablation for recurrent primary hyperparathyroidism in four patients with multiple endocrine neoplasia type 1: a case series report

Figures & data

Table 1. Clinical data of the four MEN1 patients with postoperative recurrence of PHPT.

	Case 1	Case 2	Case 3	Case 4
Age (years)	44	48	47	18
Gender	Female	Male	Male	Female
Primary tumor	Pancreas	Parathyroid gland	Pancreas	Pituitary
Course of hypercalcemia	6 months	10 years	3 years	1 year
Surgical procedures	Resection of right inferior parathyroid gland	Resection of left inferior parathyroid gland	Resection of right inferior parathyroid gland	Resection of bilateral inferior parathyroid glands
Pathology	Parathyroid hyperplasia	Parathyroid hyperplasia	Parathyroid adenoma	Parathyroid adenoma
Remnant parathyroid glands	Suspected infusion of two lesions in the superior poles of the right parathyroid glands (3.10 cm × 0.90 cm); a lesion in the superior pole of the left parathyroid gland (0.93 cm × 0.46 cm)	A lesion in the inferior lobe of the right thyroid gland (1.21 cm × 0.42 cm); a lesion in the inferior lobe of the left thyroid gland (1.36 cm × 0.64 cm)	A lesion in the inferior lobe of the left parathyroid gland (0.69 cm × 0.39 cm)	A lesion in the superior pole of the right parathyroid gland (0.34 cm × 0.28 cm); a lesion in the superior pole of the left parathyroid gland (0.50 cm × 0.31 cm)
Other neuroendocrine tumors
Pituitary		Pituitary microadenoma	Pituitary adenoma	Pituitary adenoma
Thymus
Pancreas-gut	Pancreas neuroendocrine tumor	pancreatic tumor	pancreas neuroendocrine tumor
Target organ injury	Osteoporosis	Kidney stones	Kidney stones

MEN1: multiple endocrine neoplasia type 1; PHPT: primary hyperparathyroidism.

Table 2. MEN1 genetic detecting analysis.

	Gene	Inheritance mode	Chromosomal location	Nucleotide alteration	Amino acid alteration	Homozygous/heterozygous
Case 1	MEN1 NM_130799	Autosomal dominant (AD)	chr11:64572118-64572119	Exon 10, c.1520delG	p.G507Afs*52	heterozygous
Case 2	MEN1 NM_130799	Autosomal dominant (AD)	chr11:64572118-64572119	Exon 10, c.1520delG	p.G507Afs*52	heterozygous
Case 3	MEN1 NM_000244	Autosomal dominant (AD)	chr11:64573714	Exon 10, c.1053delT	p.(T351fs)	heterozygous
Case 4	MEN1 NM_000244	Autosomal dominant (AD)	chr11:64573714	Exon 10, c.1053delT	p.(T351fs)	heterozygous

MEN1: multiple endocrine neoplasia type 1.

Figure 1. Postoperative pathological images of Case 1 (A), Case 3 (B) and Case 4 (C) after the first time of subtotal parathyroidectomy.

Figure 2. Representative imaging scans of cases 1–4 before and after thermal ablation.

Table 3. Changes in blood calcium and PTH levels after thermal ablation.

	Case 1		Case 2		Case 3		Case 4
	PTH(pg/mL)	Ca(mmol/L)	PTH(pg/mL)	Ca(mmol/L)	PTH(pg/mL)	Ca(mmol/L)	PTH(pg/mL)	Ca(mmol/L)
Pre-ablation	248.6	2.69	97.53	2.72	82.64	2.62	113	2.63
10 min	30.02	2.68	38.79	2.66	25.6	2.54	61.78	2.67
20 min	25.47	2.61	34.68	2.67	30.73	2.53	64.7	2.7
1 d	19.65	2.33	45.36	2.35	39.32	2.35	73.97	2.63
1 m	63.8	2.01	54.53	2.35	69.83	2.38	100.7	2.5
2 m	57.9	2.35	60.24	2.35	55.12	2.4	197.2	2.39
3 m	43.7	2.38	61.5	2.38	75.6	2.36
6 m	27.8	2.19	7.89	2.47	71.8	2.35	101.5	2.56
12 m	39.1	2.19			44.49	2.46
18 m	28.3	2.36

PTH: parathyroid hormone.

Data availability statement

All data are made available by the authors on request without undue reservation.