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The Oncologist, Vol. 12, No. 6, 644-653, June 2007; doi:10.1634/theoncologist.12-6-644
© 2007 AlphaMed Press

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Endocrinology

Primary Hyperparathyroidism

James W. Suliburka, Nancy D. Perrierb

aUniversity of Texas Medical School at Houston, Department of General Surgery, Houston, Texas, USA; bThe University of Texas M.D. Anderson Cancer Center, Department of Surgical Oncology, Houston, Texas, USA

Key Words. Primary hyperparathyroidism • Hypercalcemia • Parathyroidectomy • Asymptomatic hyperparathyroidism

Correspondence: Nancy D. Perrier, M.D., F.A.C.S., P. O. Box 301402, Unit 444, Houston, Texas 77230-1402, USA. Telephone: 713-794-1345; Fax: 713-745-1462; e-mail: nperrier{at}mdanderson.org

Primary hyperparathyroidism (PHPT) is classically thought of as the somatic manifestation of hypercalcemia in which patients suffer from a variety of complaints including abdominal pain, nephrolithiasis, osteopenia, and mental status changes. Contemporary PHPT patients are generally free of somatic manifestations and are most often diagnosed when routine biochemical testing shows an elevated serum calcium level. The modern day patient may present with much more subtle neurocognitive symptoms including fatigue, lethargy, muscle weakness, depression, and cognitive impairment. Advances in imaging technology, intraoperative parathyroid hormone measurement, and surgical technique now allow parathyroidectomy to be performed using a focused approach without the absolute need of a four-gland exploration. Minimally invasive techniques allow the procedure to be accomplished under local anesthesia on an outpatient basis. This brief review summarizes the presentation, biochemical evaluation, operative intervention, and follow-up care of the modern day PHPT patient.

Disclosure of potential conflicts of interest is found at the end of this article.




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