Update on the current management of persistent and recurrent primary hyperparathyroidism after parathyroidectomy

Figure 1 Causes of primary hyperparathyroidism. Single parathyroid adenoma (80%-85%), double adenoma (4%-5%), diffuse hyperplasia (10%-15%), parathyroid cancer (< 1%).

Figure 2 Causes of persistent-recurrent primary hyperparathyroidism. Adenoma (68%), parathyroid hyperplasia (28%), parathyroid carcinoma (3%), other causes: i.e. parathyromatosis, autograft relapse (1%).

Figure 3 Scheme of diagnostic approach for persistent or recurrent primary hyperparathyroidism. pHPT: Primary hyperparathyroidism; PTH: Parathyroid hormone; SPECT: Single-photon emission computed tomography; MRI: Magnetic resonance imaging; CT: Computed tomography; PET: Positron emission tomography.

Figure 4 Scheme of treatment approach for persistent or recurrent primary hyperparathyroidism (adenoma). pHPT: Primary hyperparathyroidism; PTH: Parathyroid hormone.

Figure 5 Scheme of treatment approach for persistent or recurrent primary hyperparathyroidism (diffuse hyperplasia). pHPT: Primary hyperparathyroidism; PTH: Parathyroid hormone.