a modern approach to the diagnosis and management of primary hyperparathyroidism

Primary hyperparathyroidism (pHPT) is currently being diagnosed with increased frequency. This short review demonstrates why surgery is the only curative treatment for patients with pHPT, and why intra-operative measurement of parathyroid hormone (PTH) may not be necessary in all cases of parathyroidectomy. The majority of parathyroid adenomas can be detected by pre-operative localization with 99m Tc-sestamibi and or neck ultrasound (US). The development of focused parathyroidectomy and other minimally invasive techniques has rendered day-case parathyroidectomy a safe and feasible procedure. Parathyroidectomy, either unilateral or bilateral, when considered necessary, should be performed by an experienced parathyroid surgeon.