Introduction: Primary hyperparathyroidism (PHPT) is a frequent disease. It is characterized by hypercalcemia and elevation of parathyroid hormone (PTH) levels. The incidence is variable, being more frequent in women (3:1) in the perimenopauseal period. In the last decades, diagnosis of asymptomatic PHPT has increased due to automatized calcium determinations. Duration of the disease and serum concentrations of calcium and PTH determine symptomatology. Surgery is the definitive treatment. It is important to assess surgical criteria in asymptomatic patients. Successful treatment of this disease depends on a highly specialized team of parathyroid surgeons.
Material and methods: We reviewed the clinical and biochemical background of patients subjected to parathyroidectomy from January 1998 to August 2003 in our medical center. We then analyzed clinical and laboratory data, final histopathologic diagnosis, and surgery outcome.
Results: Sixty seven patients were included, with an average age of 50 years (+/- 11.9), 15 men and 52 women. Greatest frequency of PHPT was observed in patients between 40 and 60 years of age. Average calcium value was 11.7 mg/dl (+/- 1.23) and that of PTH was 194.5 pg/ml (+/- 93). Histopathologic diagnosis was adenoma in 56 (83.58%), hyperplasia in 9 (13.43%), and carcinoma in 2 (2.9%) patients. Cure of the disease was achieved in 65 patients (97%). PHPT is a surgically curable disease; it is necessary to confirm diagnosis and decide on surgical treatment in accordance with established criteria even if the disease is asymptomatic.