Diagnosis and Management of Parathyroid Adenoma

Abstract

Background:   Parathyroid adenoma is the leading cause of primary hyperparathyroidism and is characterized by excessive secretion of parathyroid hormone, resulting in hypercalcemia and a wide range of skeletal and nonskeletal complications. Timely diagnosis and appropriate surgical treatment are crucial to reducing long term morbidity. This study was conducted to assess the clinical presentation, diagnostic approaches, and surgical outcomes of patients with parathyroid adenoma. 
Methods:  This descriptive cross-sectional study was carried out in the Department of Otolaryngology and Head Neck Surgery at Combined Military Hospital (CMH), Dhaka, between February 2018 and January 2019. Twenty four patients with confirmed parathyroid adenoma who underwent surgery were included in the study. Information was collected from clinical records, laboratory reports, imaging studies, and operative notes using a structured data collection form. Variables analyzed included demographic characteristics, clinical features, serum calcium and parathyroid hormone levels, imaging findings, surgical procedures, and postoperative outcomes. Statistical analysis was performed using SPSS version 20.0. 
Results:  The mean age of the patients was 40 years, and females accounted for 79 percent of the study population. Skeletal symptoms were the most common presentation, occurring in 66.6 percent of cases. Mean preoperative parathyroid hormone levels were markedly elevated at 788.7 and showed a substantial reduction after surgery to a mean value of 147.3. Technetium 99m sestamibi scanning successfully localized the affected gland in 75 percent of patients. All patients underwent unilateral neck exploration. A single gland adenoma was identified in 95.8 percent of cases. Biochemical cure was achieved in every patient, with 100 percent one year survival and no evidence of disease recurrence during follow up. 
Conclusion:  Parathyroidectomy remains a safe and highly effective treatment for parathyroid adenoma, producing excellent biochemical and clinical outcomes. Early surgical intervention offers the best opportunity for complete cure and helps to prevent the long-term complications associated with hyperparathyroidism. 

Bangladesh Armed Forces Med J Vol 59 No (1) June 2026, pp 77-82