Clinical Spectrum and Surgical Management of Parathyroid Adenoma: A Retrospective Observational Study

Abstract

Background: Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by inappropriate parathyroid hormone secretion, most commonly due to parathyroid adenoma. In developing countries, patients often present with advanced symptomatic disease.

Objective: To document the clinical spectrum, diagnostic evaluation, and management strategies of parathyroid adenoma in a tertiary care hospital.

Methods: This institution-based retrospective observational study included 21 patients who underwent surgery for parathyroid adenoma over a five-year period. Diagnosis was confirmed by postoperative histopathological examination. Clinical presentation, biochemical parameters, imaging findings, and anatomical location of adenomas were analyzed.

Results: The majority of patients were symptomatic, with fatigue, renal colic, renal calculi, and skeletal manifestations being the most common presentations. All patients demonstrated markedly elevated serum parathyroid hormone levels and hypercalcemia, along with reduced bone mineral density. Multimodality imaging aided accurate localization, with the left inferior parathyroid gland being the most frequent site.

Conclusion: Parathyroid adenoma in the Indian population frequently presents late with significant skeletal and renal morbidity. Early recognition, appropriate imaging, and surgical excision result in favorable biochemical and clinical outcomes.