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Primary hyperparathyroidism associated with MEN 1: Experience in 71 cases.
María Balsalobre Salmeron1, Jose Manuel Rodriguez Gonzalez2, Antonio Ríos2
1Unidad de Cirugía Endocrina, Hospital Universitario Santa Lucia, Cartagena, Murcia, España.
Cirugia Espanola
|July 31, 2018
Summary
Primary hyperparathyroidism (pHPT) in Multiple Endocrine Neoplasia type 1 (MEN 1) often recurs. Surgical technique and follow-up duration are key risk factors for recurrence in pHPT patients.
Area of Science:
- Endocrinology
- Genetics
- Surgical Oncology
Background:
- Primary hyperparathyroidism (pHPT) in Multiple Endocrine Neoplasia type 1 (MEN 1) presents as multiglandular disease with variable parathyroid gland involvement.
- Recurrence rates for pHPT in MEN 1 range from 25% to 35%.
Purpose of the Study:
- To describe the clinical experience and treatment of patients with pHPT in MEN 1.
- To analyze factors associated with the clinical presentation and recurrence of pHPT in MEN 1 patients.
Main Methods:
- Retrospective analysis of 71 patients with pHPT diagnosed in a tertiary hospital.
- Evaluation of variables including age at diagnosis, mutation status, clinical presentation, laboratory results, surgical technique, and recurrence of hyperparathyroidism.
Main Results:
- The mean age at diagnosis was 38 years, with 50 patients being asymptomatic.
- Subtotal parathyroidectomy was the most common surgical technique (n=55).
- A recurrence rate of 21% was observed, with correlations found between age at diagnosis, serum calcium levels, symptoms, surgical technique, follow-up time, and recurrence.
Conclusions:
- Genetic and clinical screening enable early diagnosis and treatment of HPT in MEN 1, even during the asymptomatic phase.
- High recurrence rates underscore the significance of follow-up duration and surgical technique as critical risk factors.
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