Korean J Endocr Surg.  2003 Apr;3(1):26-31. 10.16956/kjes.2003.3.1.26.

The Experience of Surgical Management for Parathyroid Hyperplasia

• Jung PJ
• Lee KH
• Kim HJ

• KMID: 2376147
• DOI: http://doi.org/10.16956/kjes.2003.3.1.26

Abstract

Parathyroid hyperplasia is a pathologic finding that can be found in hyperparathyroidism. Unlike parathyroid adenoma, treatment of parathyroid hyperplasia is still quite controversial. In addition, the relative merits of two alternative surgical approaches-subtotal parathyroidectomy versus total parathyroidectomy with autotransplantation have not been clearyly elucidated. The records of 10 patients who had parathyroid hyperplaisa and who underwent parathyroid surgery at the Department of Surgery, Hanyang University Hospital, between April 1992 and April 2003 were retrospectively reviewed. The 10 patients were comprised of 3 males and 7 females. The age distribution was between 29 and 73 years. The presenting clinical manifestations were associated with bone pain in 8 patients, muscle weakness in 4, headache in 4, gastrointestinal symptoms in 3, renal symptoms in 3 and psychologic symptoms in 2. The serum parathyroid hormone level was elevated in all patients. The serum alkaline phosphatase level was elevated in seven among the ten patients. Histopathologic findings revealed chief cell hyperplasia in all patients. Postoperative transient hypocalcemia occurred in 5 patients and they were supplied with oral calcium and calcitriol for several months. There were no major complications. The results indicate that a subtotal parathyroidectomy can be performed without mortality or morbidity and provides good control of primary parathyroid hyperplasia, A total prathyroidectomy with autotransplantation can be performed without mortality or morbidity and provides good contril of secondary and tertiary parathyroid hyperplaisa.

Keyword

Parathyroid hyperplasia; Hyperparathyroidism; Subtotal parathyroidectomy; Total prathyroidectomy; Parathyroid autotransplantation

MeSH Terms

Age Distribution
Alkaline Phosphatase
Autografts
Calcitriol
Calcium
Female
Headache
Humans
Hyperparathyroidism
Hyperplasia*
Hypocalcemia
Male
Mortality
Muscle Weakness
Parathyroid Hormone
Parathyroid Neoplasms
Parathyroidectomy
Retrospective Studies
Transplantation, Autologous
Alkaline Phosphatase
Calcitriol
Calcium
Parathyroid Hormone