Hyperparathyroidism due to single gland enlargement: prospective postoperative study

D. C. Purnell, D. A. Scholz and O. H. Beahrs

Subtotal parathyroidectomy in all patients with primary hyperparathyroidism has been proposed by several authors. Their data suggest that hyperparathyroidism may recur in up to 30% of patients treated by a conservative operation. This recurrence is attributed to chief-cell hyperplasia as the pathology in one third to one half of all patients. A conservative operation was performed on 198 hyperparathyroid patients with a single enlarged parathyroid gland between 1968 and 1970. Mild elevation of the serum calcium level was noted in two patients three months after operation. Normal serum calcium values were noted each time they were measured in the remaining patients. The present study does not support subtotal parathyroidectomy in all patients with hyperparathyroidism.