Recurrent hyperparathyroidism in kidney failure patients after total parathyroidectomy and autotransplantation. Case report and review of the literature

: We present the case of a 57-year old man who underwent total parathyroidectomy with autotransplantation into the brachioradial muscle (Wells' method) due to secondary hyperparathyroidism as a complication of chronic renal failure. Three years later the patient developed recurrent secondary hyperparathyroidism due to graft hyperplasia resulting in the removal of the graft. We point out various problems associated with Wells' method and discuss alternative surgical techniques.