Diagnóstico de localización del hiperparatiroidismo primario

Primary hyperparathyroidism (PHPT) is a common endocrine disease. The presence of PHPT should be suspected in patients with persistent, often mild, hypercalcemia in the absence of any other apparent etiology. Hyperparathyroidism is the most frequent cause of hypercalcemia in the outpatient setting and is usually discovered incidentally by routine laboratory testing. Currently, most patients are asymptomatic. The only permanently effective therapy for patients with PHPT is surgery, with a high cure rate (95%) and few perioperative complications (5%). Parathyroid imaging is not required in the diagnosis of PHPT. The role of preoperative localization in patients undergoing initial neck exploration is unclear, since a bilateral approach in the hands of experienced surgeons achieves a high cure rate. Preoperative localization of adenomas with ultrasonography or sestamibi scanning allows a minimally invasive approach to be used. Localization studies are required when PHPT persists or recurs after surgery.