The Outcome of Subtotal Parathyroidectomy for the Treatment of Hyperparathyroidism in Multiple Endocrine Neoplasia Type 1

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Abstract
THE ROLE of parathyroidectomy in the management of sporadic primary hyperparathyroidism (PHPT) is well established. The cure rate exceeds 90%.1 Persistent and recurrent PHPT after operation usually occurs in the presence of multiple gland parathyroid disease, multiple adenomas, or diffuse hyperplasia of the parathyroid glands.2,3 Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant condition typified by hyperplasia of the parathyroid glands, gastroenteropancreatic neuroendocrine neoplasia, and pituitary neoplasia.4-6 Primary hyperparathyroidism is the most prevalent abnormality in MEN 1, occurring in virtually all persons who inherit the underlying gene defect.6 Hypercalcemia is often the first manifestation of MEN 1; biochemical disease usually becomes detectable during the second or third decade of life. The optimal timing and type of parathyroidectomy for patients with MEN 1, however, remain controversial.