Two men on dialysis and a woman with benign parathyroid hyperplasia were the first to receive parathyroid thermal ablation treatment at the Onco-interventional Unit of the Heart and Vascular Centre at Semmelweis University in Budapest, Hungary.
“The procedure involved inserting a needle into the lesion through a small pinprick-sized hole, then heating the surrounding tissue using microwaves. The intervention aims to precipitate proteins in the tumour cells due to the heat and cuts off the blood supply to the tumour. This allows the body to break down the dead tissue over time,” says Dr. Pál Ákos Deák, head of the Onco-Interventional Unit. Dr. Deák highlighted the technical challenges, emphasising the need to separate tissues with fluid to protect vital structures like the trachea, oesophagus, and the nerves responsible for the movement of the vocal cords from heat-related complications.
The team had previously used the same technique to treat liver, kidney, thyroid and bone tumours. However, parathyroid treatment via thermal ablation had not been performed in Hungary or the broader region before, except in Spain and Italy.
Gallery
They use a high-resolution ultrasound machine to visualise the often deeply embedded lesions during the procedure properly.
The lesions are sometimes only a few millimetres in size, so they are difficult to access. We need a steady hand to guide the needle into the right position safely,
explains Dr. Deák.
The intervention can be successful in one session, but recurrence may occur years later. The procedure can be repeated several times without compromising subsequent operations, unlike open surgery, where a second or even third operation on a previously operated neck can lead to complications. Patients undergoing multiple open surgeries can also undergo this procedure.
Semmelweis University experts performed the first three thermal ablation treatments for benign parathyroid tumours under the supervision of Dr. Bülent Cekic, a world-renowned expert from Turkey. Following the successful procedures, the Onco-Interventional team is preparing for additional operations using the same technology.
Patients under nephrological and endocrinological care can apply for the procedure through Hungarian national health insurance. Eligibility is determined by a board of experts.
Hyperparathyroidism – an overproduction of parathyroid hormone – upsets the body’s calcium and phosphate metabolism. In most cases, an enlargement of the parathyroid gland, a benign or a malignant tumour causes the increased parathyroid function. For cancerous parathyroid, head and neck surgery remains the treatment of choice in the first line. Hyperparathyroidism can occur in both primary and secondary forms, including in patients undergoing renal transplantation. It is essential to keep people on the transplant list to ensure that they receive appropriate treatment: the disease is often difficult to control with medication, but now thermal ablation is available to correct the abnormalities that cause parathyroid hormone overproduction.
Photo: Balint Barta – Semmelweis University
