Parathyroid surgery in multiple endocrine neoplasia type 1

T. K. Pandian, Eee LN H. Buckarma, David R. Farley

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Primary hyperparathyroidism (PHPT) is the most common condition in patients with multiple endocrine neoplasia type 1 (MEN-1). Asymmetric, multi-gland disease due to multiple adenomas is characteristic in this cohort. The principal treatment of PHPT in MEN-1 patients is surgical. Options for surgical excision include subtotal (subPTX) or total parathyroidectomy with autotransplantation (totPTX). The optimal operation for these patients remains controversial. A 2011 systematic review and meta-analysis found no major difference in recurrence or persistence between subPTX and totPTX, but there were lower rates of hypocalcemia following subPTX. Recurrent PHPT in MEN-1 patients who have undergone initial parathyroidectomy is a challenging problem that should involve the input of experienced endocrine surgeons and endocrinologists. Alternative strategies such as alcohol ablation and cinacalcet administration may be warranted in some of these patients.

Original languageEnglish
Title of host publicationHyperparathyroidism
Subtitle of host publicationA Clinical Casebook
PublisherSpringer International Publishing
Number of pages11
ISBN (Electronic)9783319258805
ISBN (Print)9783319258782
StatePublished - Jan 1 2016


  • Alcohol ablation
  • Autotransplantation
  • Cinacalcet
  • Multiple endocrine neoplasia 1
  • Primary hyperparathyroidism
  • Recurrent hyperparathyroidism
  • Subtotal parathyroidectomy
  • Total parathyroidectomy


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