[Primary hyperparathyroidism: diagnostic and therapeutic trends]

Area of Science:

• Endocrinology
• Surgical Oncology
• Nuclear Medicine

Context:

• Primary hyperparathyroidism (PHPT) diagnosis is increasing, often incidentally discovered via hypercalcemia.
• Debate continues regarding parathyroidectomy for asymptomatic patients and advancements in video-assisted surgical techniques.
• This study retrospectively analyzes 31 PHPT cases, focusing on clinical presentation, diagnostics, and surgical outcomes.

Purpose:

• To evaluate the diagnostic accuracy of MIBI scintigraphy in primary hyperparathyroidism.
• To assess the efficacy and safety of surgical interventions for PHPT.
• To review current diagnostic and therapeutic strategies for parathyroid disease.

Summary:

• MIBI scintigraphy demonstrated high diagnostic reliability, identifying 83.6% of diseased parathyroids.
• Surgical treatment included parathyroidectomy (simple, bilateral, or subtotal) and associated thyroid procedures in 8 cases.
• No mortality was observed; morbidity included transient paresthesia in 9.6% of patients.

Impact:

• Reinforces MIBI scintigraphy as the gold standard for PHPT diagnosis.
• Supports surgical treatment as the primary option for symptomatic PHPT.
• Highlights the importance of tailored surgical strategies based on the underlying parathyroid pathology (adenoma, hyperplasia, carcinoma).