Abstract Primary hyperparathyroidism (PHPT) is characterized by hypercalcemia caused by excessive secretion of parathyroid hormone and is definitively treated by surgical removal of the pathological parathyroid gland. We retrospectively reviewed 39 patients with PHPT who underwent parathyroidectomy at Fujinomiya City General Hospital between 2010 and 2020. The cohort consisted of 12 men and 27 women, with a median age of 58 years. Thirty-three patients had biochemical-type PHPT, while six had renal-type PHPT. Preoperative localization was assessed using neck ultrasonography, contrast-enhanced computed tomography (CT), and technetium-99m methoxyisobutyl isonitrile (MIBI) scintigraphy. Localization of the pathological gland was successfully achieved in all patients using one or a combination of these imaging modalities. All patients underwent targeted parathyroidectomy under general anesthesia. Histopathological examination revealed adenoma in 31 cases and hyperplasia in 8 cases. No postoperative recurrent laryngeal nerve palsy was observed. Although transient hypocalcemia occurred in 19 patients, all cases improved with appropriate management. Accurate preoperative localization using multiple imaging modalities contributed to safe and effective surgical treatment. Early diagnosis and timely surgical intervention are important in the management of PHPT.
Sugawara et al. (Thu,) studied this question.