Selective catheterization of the thyroid veins for preoperative localization of parathyroid tumours

Samples obtained from the thyroid veins as well as from the great veins of the neck of 35 patients with primary hyperparathyroidism were assayed for parathyroid hormone. The overall distribution of the hormone was used to predict the location of the parathyroid tumour. In 27 patients the site of the adenoma was correctly predicted, and in a further 4 the side of the neck in which the tumour was to be found was forecast correctly; in only 4 patients was the technique unsuccessful. Thus, useful information was obtained in 31 of the 35 patients studied (88 per cent). Preoperative localization of parathyroid tumours in this way is of greater value than merely sampling large veins alone, particularly when there has been previous exploratory surgery.