Success of Reoperative Neck Surgery in Persistent Hyperparathyroidism

  • Yeşim Erbil
  • Nihat Aksakal


Sustained normocalcemia throughout postoperative 6 months is considered as a complete recovery achieved by surgery. Parathyroid hormone (PTH) and calcium levels not being reduced or becoming higher again during 6 months after the surgery are defined as persistent hyperparathyroidism, whereas hypercalcemia and high levels of PTH more than 6 months later are defined as recurrent hyperparathyroidism. The most common cause of persistent HPT is multiglandular disorder and ectopic adenomas. Persistent HPT occurs as a result of an insufficient surgery. The most critical factor that lowers the rate of HPT is surgical experience. In this article, we presented a case of 36-year-old woman with persistent hypercalcemia following an unsuccessful operation due to failure of localization of her parathyroid adenoma by conventional imaging modalities and became normocalcemic only after an operation guided by an 18F-choline PET/CT imaging spotting the adenoma in the mediastinum.


Persistent hyperparathyroidism 18F-choline PET MIBI Ectopic parathyroid adenoma Hyperparathyroidism 



The authors would like to thank Assoc. Prof. Dr. Sait Sager for providing us with 18F-fluorocholine PET/CT image (Fig. 76.1) from the archive of Cerrahpasa School of Medicine, Department of Nuclear Medicine, İstanbul, Turkey.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Yeşim Erbil
    • 1
  • Nihat Aksakal
    • 1
  1. 1.Division of Endocrine Surgeryİstanbul UniversityİstanbulTurkey

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