Parathyroid Frozen

Auto text: “Insert Parathyroid Frozen”

  1. Parathyroids often come for intraoperative consultation in order to identify parathyroid tissue or to verify a lesional (heavy, hypercellular) gland.
  2. Measure in 3 dimensions and Weigh to 3 significant digits (see below).
  3. Palpate the tissue to determine how much is glandular versus adipose. Trim off as much adipose tissue as possible. The adipose tissue is difficult to cut and does not need to be frozen.
  4. WEIGH the glandular tissue and the adipose tissue separately, using the scale in the triage area that measures to three significant digits (i.e. 234 mg or 0.234 g).
    1. Even if the fragment is small – weight all possible parathyroid fragments that come for frozen.
    2. Average parathyroid glands weigh 20-40 mg.  Increase in weight may indicate a lesional / hyperfunctional gland.
  5. If glandular tissue is thick: bisect, freeze half, and save half for permanent.
  6. Parathyroid carcinomas are RARE: If the parathyroid gland is especially large, heavy, or the surgeon noted adhesion to surrounding tissue – parathyroid carcinoma is in the differential diagnosis. In these cases, ink the outer surface before sectioning. Serially section and freeze a representative section. Photograph a representative section(s).
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