Surgical Management of Primary Hyperparathyroidism: A Study of 9 Cases

Introduction: Primary hyperparathyroidism (pHPT) is defined by an excessive secretion of parathyroid hormone (PTH) that remains elevated relative to serum calcium levels. Its incidence is steadily increasing, with a marked predominance in women. The definitive diagnosis is biological, while imaging is essential to localize the parathyroid lesion and guide surgical treatment. Objective: To analyze the epidemiological, clinical, therapeutic, and prognostic features of patients who underwent surgery for primary hyperparathyroidism. Materials and Methods: Retrospective analysis involving 9 patients who underwent surgery for primary hyperthyroidism between January 2014 and December 2017. Results: The most represented age group in our series was [60 - 80 years], the average age was 66.3 years, with an extreme at 48 and 77 years. A female predominance was observed (78%), osseous manifestations of hypercalcemia were the dominant presentation, Serum calcium levels were elevated in 100% of patients, and iPTH levels were elevated in all cases. A topographic diagnosis was made based on imaging findings, cervical ultrasound was performed on 6 patients, while cervico-thoracic CT was conducted in 56% of the cases. All patients received preoperative treatment to reduce serum calcium levels involved rehydration and diuretics. The surgical approach consisted of a classic transverse cervicotomy. Post-operative recovery was uneventful. Pathological examination revealed a parathyroid adenoma in 100% of the patients. Conclusion: Primary hyperparathyroidism (pPTH) is the most common endocrine disorder in adults after thyroid diseases. It is incidentally discovered in more than 50% of the cases. Surgical intervention remains the definitive treatment of symptomatic forms, despite emerging medical alternatives. Transverse cervicotomy has proven effective and remains a reliable and accessible treatment option in our context, until minimally invasive surgery become more widely available.