Ninety-five percent of PHPT cases are sporadic. Of these cases, 75–85% result from a single adenoma, 2–12% result from double adenomas, 10–15% result from multiple gland hyperplasia, and <1% result from parathyroid carcinoma.

Patients with multigland disease tend to have PTH levels of <100 pg/mL, a negative preoperative localization, or several neurocognitive symptoms. Serum calcium levels of >14 mg/dL (3.5 mmol/L) or a palpable neck mass with elevated PTH may indicate parathyroid carcinoma [17]. Familial endocrine disorders occur in approximately 5% of PHPT cases and frequently present in younger populations with a positive family history of neuroendocrine tumors or hypercalcemia.

For complete article https://www.omicsonline.org/open-access/2-current-concepts-in-the-presentation-diagnosis-and-management-of-primary-hyperparathyroidism-1584-9341-10-4-2.pdf.php?aid=38113

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