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  • Title: Can parathyroid hyperplasia be predicted preoperatively?
    Author: McHenry CR, Shi HH.
    Journal: Am J Surg; 2018 Mar; 215(3):389-392. PubMed ID: 29174770.
    Abstract:
    INTRODUCTION: The purpose of this study was to determine if there are clinical features that raise suspicion for parathyroid hyperplasia. MATERIALS & METHODS: We retrospectively reviewed patients with primary hyperparathyroidism who underwent parathyroidectomy from 1991 to 2017, analyzing demographics, calcium and PTH, and localizing studies for patients with hyperplasia and single adenoma. RESULTS: 549 patients underwent parathyroidectomy: 464 (85%) with adenoma, 44 (8%) with double adenoma, 38 (7%) with hyperplasia, and 3 (1%) with cancer. Compared to patients with a single adenoma, patients with hyperplasia were more likely to have negative sestamibi, ultrasound or both exams (92% vs 6%, p < 0.001; 96% vs 4%, p < 0.001; and 91% vs 2%, p < 0.001) and lower gland weights (619 ± 1067 mg vs. 1466 ± 1899 mg, p < 0.001). CONCLUSION: Parathyroid hyperplasia should be suspected in patients with lower gland weights and negative imaging.
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