Surgery of hyperparathyroidism: a conservative approach

The extent of surgery in the treatment of primary hyperparathyroidism should be based on the pathologic entity of the disease. In neoplasia (either the common adenoma or the rare carcinoma), excision of the diseases parathyroid will generally suffice to cure the disease, but in primary hyperplasia, the removal of all the diseased glands except for a small amount of glandular tissue is required. The pathologic diagnosis of primary hyperparathyroidism can usually be made by a macroscopic assessment of the parathyroid. It is further delineated by the density test and confirmed by Sudan fat-frozen section examination.