Key Clinical Message
Primary hyperparathyroidism is the most common cause of hypercalcemia in
unselected patients. The diagnosis mandates inappropriately high PTH
levels despite upper normal/elevated Ca++ serum
levels. Negative imaging studies neither exclude the diagnosis nor
contraindicates the operative approach. Open, bilateral 4-gland
exploration offers the best chance of cure in this setting.
Keywords: Primary Hyperparathyroidism, Parathyroid Adenoma,
Neck Exploration, Parathyroidectomy, Neck U/S, Sesta-MIBI Scanning