Primary hyperparathyroidism (PHPT) is primarily treated with surgery, achieving a 95% cure rate when performed by skilled surgeons. However, 4–5% of patients experience persistent or recurrent PHPT post-surgery due to factors such as undetected adenomas or misdiagnoses like familial hypocalciuric hypercalcemia (FHH). Despite advancements in intraoperative parathormone monitoring and preoperative imaging, some cases remain challenging due to ectopic gland locations and other factors. This underscores the need for multidisciplinary approaches and thorough preoperative planning to enhance surgical outcomes in PHPT management.
Uludag M, Unlu MT, Kostek M, et al. Persistent and recurrent primary hyperparathyroidism: etiological factors and pre-operative evaluation. Sisli Etfal Hastan Tip Bul 2023;57(1):1–17. DOI: 10.14744/SEMB.2023.39260.
Foroulis CN, Rousogiannis S, Lioupis C, et al. Ectopic paraesophageal mediastinal parathyroid adenoma, a rare cause of acute pancreatitis. World J Surg Oncol 2004;2:41. DOI: 10.1186/1477-7819-2-41.
Zhu J, Tian W, Xu Z, et al. Expert consensus statement on Parathyroid protection in Thyroidectomy. Ann Transl med 2015:3(16):230. DOI: 10.3978/j.issn 2305-5839.2015.08.20.
Hillyar CR, Rizki H, Begum R, et al. A retrospective cohort study of the utility of ultrasound, 99mtc-sestamibi scintigraphy, and four-dimensional computed tomography for pre-operative localization of parathyroid disease to facilitate minimally invasive parathyroidectomy. Cureus 2022;14(1):e21177. DOI: 10.7759/cureus.21177.
Park HS, Hong N, Jeong JJ, et al. Update on preoperative parathyroid localization in primary hyperparathyroidism. Endocrinol Metab 2022;37(5):744–755. DOI: 10.3803/EnM.2022.1589.
Catalfamo A, Famà F, Pergolizzi FP, et al. Management of undetectable and lost parathyroid adenoma. Annals of Thyroid 2018;3(1). DOI: 10.21037/aot.2017.12.02.
Jones JM, Russell CF, Ferguson WR, Laird JD. Pre-operative sestamibi-technetium subtraction scintigraphy in primary hyperparathyroidism: experience with 156 consecutive patients. Clin Radiol 2001;56: 556–559. DOI: 10.1053/crad.2001.0701.
Mazarico-Altisent I, Capel I, Baena N, et al. Novel germline variants of CDKN1B and CDKN2C identified during screening for familial primary hyperparathyroidism. J Endocrinol Invest 2023;46(4):829–840. DOI: 10.1007/s40618-022-01948-7.
Hessman O, Stålberg P, Sundin A, et al. High success rate of parathyroid reoperation may be achieved with improved localization diagnosis. World J Surg 2008;32(5):774–781. DOI: 10.1007/s00268-008-9 537-5.
Mazotas IG, Yen TWF, Doffek K, et al. Persistent/recurrent primary hyperparathyroidism: does the number of abnormal glands play a role? J Surg Res 2020;246:335–341. DOI: 10.1016/j.jss.2019. 08.007.
Reitz RJ 3rd, Dreimiller A, Khil A, et al. Ectopic and supernumerary parathyroid glands in patients with refractory renal hyperparathyroidism. Surgery 2021 Mar;169(3):513–518. DOI: 10.1016/j.surg.2020. 08.007.
