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Parathyroid Surgery in Multiple Endocrine Neoplasia Type 1

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Hyperparathyroidism

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Abstract

Primary hyperparathyroidism (PHPT) is the most common condition in patients with multiple endocrine neoplasia type 1 (MEN-1). Asymmetric, multi-gland disease due to multiple adenomas is characteristic in this cohort. The principal treatment of PHPT in MEN-1 patients is surgical. Options for surgical excision include subtotal (subPTX) or total parathyroidectomy with autotransplantation (totPTX). The optimal operation for these patients remains controversial. A 2011 systematic review and meta-analysis found no major difference in recurrence or persistence between subPTX and totPTX, but there were lower rates of hypocalcemia following subPTX. Recurrent PHPT in MEN-1 patients who have undergone initial parathyroidectomy is a challenging problem that should involve the input of experienced endocrine surgeons and endocrinologists. Alternative strategies such as alcohol ablation and cinacalcet administration may be warranted in some of these patients.

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Conflicts of Interest

All authors state that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Mayo College of Medicine, Mayo Clinic, Rochester, MN, USA

    T. K. Pandian MD, MPH, EeeLN H. Buckarma MD & David R. Farley MD

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  1. T. K. Pandian MD, MPH
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  2. EeeLN H. Buckarma MD
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  3. David R. Farley MD
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Corresponding author

Correspondence to David R. Farley MD .

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Editors and Affiliations

  1. Mayo Clinic, Rochester, Minnesota, USA

    Ann E. Kearns

  2. Mayo Clinic, Rochester, Minnesota, USA

    Robert A. Wermers

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© 2016 Mayo Foundation for Medical Education and Research

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Pandian, T.K., Buckarma, E.H., Farley, D.R. (2016). Parathyroid Surgery in Multiple Endocrine Neoplasia Type 1. In: Kearns, A., Wermers, R. (eds) Hyperparathyroidism. Springer, Cham. https://doi.org/10.1007/978-3-319-25880-5_9

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  • DOI: https://doi.org/10.1007/978-3-319-25880-5_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25878-2

  • Online ISBN: 978-3-319-25880-5

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