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Surgical Management of Known Multiglandular Parathyroid Disease

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Medical and Surgical Treatment of Parathyroid Diseases

Abstract

The majority of patients presenting with hyperparathyroidism have a single adenoma responsible for elevated parathyroid hormone levels. However, in about 10–15 % of cases, two or more parathyroid glands are involved in the disease process. Thus, any surgical intervention must address all diseased glands in order to provide benefit to the patient. While multiglandular disease is commonly sporadic, multiple other factors may lead to gland enlargement, including drugs such as lithium, renal disease, and genetic disorders such as multiple endocrine neoplasia; in these instances significantly more investigation and/or treatment is required than in those patients with sporadic disease. Thus, the clinician must carry a heightened level of suspicion for other causes of disease when multiglandular disease is recognized.

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References

  1. Wells SA, Christiansen C. The transplanted parathyroid gland: evaluation of cryopreservation and other environmental factors which affect its function. Surgery. 1974;75(1):49–55. Population/Observational Study; Level 4.

    CAS  PubMed  Google Scholar 

  2. McHenry CR, Stenger DB, Calandro NK. The effect of cryopreservation on parathyroid cell viability and function. Am J Surg. 1997;174(5):481–4. Population/Observational Study; Level 4.

    Article  CAS  PubMed  Google Scholar 

  3. Shepet K, Alhefdhi A, Usedom R, Sippel R, Chen H. Parathyroid cryopreservation after parathyroidectomy: a worthwhile practice? Ann Surg Oncol. 2013;20(7):2256–60. Population/Observational Study; Level 4.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lundgren E, Rastad J, Thrufjell E, Akerström G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997;121(3):287–94. Population/Observational Study; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  5. Macfarlane DP, Yu N, Leese GP. Subclinical and asymptomatic parathyroid disease: implications of emerging data. Lancet Diabetes Endocrinol. 2013;1(4):329–40. Clinical Review; Level 2; Grade A.

    Article  PubMed  Google Scholar 

  6. Bilezikian JP, Brandi ML, Eastell R. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99(10):3561–9. Clinical Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  7. Akerström G, Bergström R, Grimelius L. Relation between changes in clinical and histopathological features of primary hyperparathyroidism. World J Surg. 1986;10(4):696–702. Population/Observational Study; Level 4.

    Article  PubMed  Google Scholar 

  8. Sneider MS, Solorzano CC, Montano RE, Anello C, Irvin GL, Lew JI. Sporadic primary hyperparathyroidism in young individuals: different disease and treatment? J Surg Res. 2009;155(1):100–3. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  9. Arnold A, Kim HG, Gaz RD. Molecular cloning and chromosomal mapping of DNA rearranged with the parathyroid hormone gene in a parathyroid adenoma. J Clin Invest. 1989;83(6):2034–40. Basic Science; Level 4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Newey PJ, Nesbit MA, Rimmer AJ. Whole-exome sequencing studies of nonhereditary (sporadic) parathyroid adenomas. J Clin Endocrinol Metab. 2012;97(10):E1995–2005. Basic Science; Level 2; Grade A.

    Google Scholar 

  11. Carling T, Kindmark A, Hellman P. Vitamin D receptor genotypes in primary hyperparathyroidism. Nat Med. 1995;1(12):1309–11. Population/Observational Study; Level 4.

    Article  CAS  PubMed  Google Scholar 

  12. Szabo E, Lundgren E, Juhlin C, Ljunghall S, Akerström G, Rastad J. Double parathyroid adenoma, a clinically nondistinct entity of primary hyperparathyroidism. 1998. World J Surg. 1998;22(7):708–13. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  13. Bruining HA, van Houten H, Juttmann JR, Lamberts SW, Birkenhäger JC. Original scientific reports. Results of operative treatment of 615 patients with primary hyperparathyroidism. World J Surg. 1981;5(1):85–90. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  14. Rajaei MH, Oltmann SC, Schneider DF, Sippel RS, Chen H. Outcomes after subtotal parathyroidectomy for primary hyperparathyroidism due to hyperplasia: significance of whole vs. partial gland remnant. Ann Surg Oncol. 2015;22(3):966–71. Population/Observational Study; Level 2; Grade B.

    Article  PubMed  Google Scholar 

  15. Yen TW, Wang TS. Subtotal parathyroidectomy for primary hyperparathyroidism. Endocrine Pract. 2011;17 Suppl 1:7–12. Clinical Review; Level 3; Grade A.

    Article  Google Scholar 

  16. Tisell LE, Hedman I, Hansson G. Clinical characteristics and surgical results in hyperparathyroidism caused by water-clear cell hyperplasia. World J Surg. 1981;5(4):565–71. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  17. Livingstone C, Rampes H. Lithium: a review of its metabolic adverse effects. J Psychopharmacol. 2006;20(3):347–55. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  18. McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379(9817):721–8. Clinical Review; Level 3; Grade A.

    Article  CAS  PubMed  Google Scholar 

  19. Broome JT, Solorzano CC. Lithium use and primary hyperparathyroidism. Endocrine Pract. 2011;17 Suppl 1:31–5. Clinical Review; Level 3; Grade A.

    Article  Google Scholar 

  20. Awad SS, Miskulin J, Thompson N. Parathyroid adenomas versus four-gland hyperplasia as the cause of primary hyperparathyroidism in patients with prolonged lithium therapy. World J Surg. 2003;27(4):486–8. Clinical Review; Level 3; Grade B.

    Article  PubMed  Google Scholar 

  21. Hundley JC, Woodrum DT, Saunders BD, Doherty GM, Gauger PG. Revisiting lithium-associated hyperparathyroidism in the era of intraoperative parathyroid hormone monitoring. Surgery. 2005;138(6):1027–31. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  22. Norlén O, Sidhu S, Sywak M, Delbridge L. Long-term outcome after parathyroidectomy for lithium-induced hyperparathyroidism. Br J Surg. 2014;101(10):1252–6. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  23. Saunders BD, Saunders EF, Gauger PG. Lithium therapy and hyperparathyroidism: an evidence-based assessment. World J Surg. 2009;33(11):2314–23. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  24. Marti JL, Yang CS, Carling T. Surgical approach and outcomes in patients with lithium-associated hyperparathyroidism. Ann Surg Oncol. 2012;19(11):3465–71. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  25. Sokol MS, Kavolius J, Schaaf M, D'Avis J. Recurrent hyperparathyroidism from benign neoplastic seeding: a review with recommendations for management. Surgery. 1993;113(4):456–61. Clinical Review; Level 3; Grade B.

    CAS  PubMed  Google Scholar 

  26. Twigt BA, van Dalen T, Vroonhoven TJ, Consten EC. Recurrent hyperparathyroidism caused by benign neoplastic seeding: two cases of parathyromatosis and a review of the literature. Acta Chir Belg. 2014;113(3):228–32. Population/Observational Study; Level 4.

    Article  Google Scholar 

  27. Matsuoka S, Tominaga Y, Sato T. Recurrent renal hyperparathyroidism caused by parathyromatosis. World J Surg. 2007;31(2):299–305. Population/Observational Study; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  28. Tublin ME, Yim JH, Carty SE. Recurrent hyperparathyroidism secondary to parathyromatosis: clinical and imaging findings. J Ultrasound Med. 2007;26(6):847–51. Population/Observational Study; Level 4.

    Article  PubMed  Google Scholar 

  29. Lairmore TC, Piersall LD, DeBenedetti MK. Clinical genetic testing and early surgical intervention in patients with multiple endocrine neoplasia type 1 (MEN 1). Ann Surg. 2004;239(5):637–45. Clinical Investigation; Level 2; Grade B.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Kouvaraki MA, Lee JE, Shapiro SE. Genotype-phenotype analysis in multiple endocrine neoplasia type 1. Arch Surg. 2002;137(6):641–7. Clinical Investigation; Level 2; Grade B.

    Article  PubMed  Google Scholar 

  31. Chandrasekharappa SC, Guru SC, Manickam P. Positional cloning of the gene for multiple endocrine neoplasia-type 1. Science. 1997;276(5311):404–7. Basic Science; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  32. Thakker RV, Bouloux P, Wooding C. Association of parathyroid tumors in multiple endocrine neoplasia type 1 with loss of alleles on chromosome 11. N Engl J Med. 1989;321(4):218–24. Clinical Investigation; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  33. Stålberg P, Carling T. Familial parathyroid tumors: diagnosis and management. World J Surg. 2009;33(11):2234–43. Clinical Review; Level 2; Grade C.

    Article  PubMed  Google Scholar 

  34. Lemos MC, Thakker RV. Multiple endocrine neoplasia type 1 (MEN1): analysis of 1336 mutations reported in the first decade following identification of the gene. Hum Mut. 2008;29(1):22–32. Clinical Investigation; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  35. Tham E, Grandell U, Lindgren E, Toss G, Skogseid B, Nordenskjöld M. Clinical testing for mutations in the MEN1 gene in Sweden: a report on 200 unrelated cases. J Clin Endo Metab. 2007;92(9):3389–95. Clinical Investigation; Level 2; Grade B.

    Article  CAS  Google Scholar 

  36. Newey PJ, Thakker RV. Role of multiple endocrine neoplasia type 1 mutational analysis in clinical practice. Endocrine Pract. 2011;17 Suppl 3:8–17. Clinical Review; Level 2; Grade A.

    Article  Google Scholar 

  37. Thakker RV, Newey PJ, Walls GV. Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endo Metab. 2012;97(9):2990–3011. Clinical Review; Level 2; Grade A.

    Article  CAS  Google Scholar 

  38. Brandi ML, Gagel RF, Angeli A. Guidelines for diagnosis and therapy of MEN type 1 and type 2. J Clin Endocrinol Metab. 2001;86(12):5658–71. Clinical Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  39. Akerström G, Stålberg P. Surgical management of MEN-1 and -2: state of the art. Surg Clin North Am. 2009;89(5):1047–68. Clinical Review; Level 2; Grade B.

    Article  PubMed  Google Scholar 

  40. Tonelli F, Marcucci T, Giudici F, Falchetti A, Brandi ML. Surgical approach in hereditary hyperparathyroidism. Endocrine J. 2009;56(7):827–41. Clinical Review; Level 2; Grade B.

    Article  Google Scholar 

  41. Demeter JG, De Jong SA, Lawrence AM, Paloyan E. Recurrent hyperparathyroidism due to parathyroid autografts: incidence, presentation, and management. Am Surg. 1993;59(3):178–81. Clinical Investigation; Level 3; Grade A.

    CAS  PubMed  Google Scholar 

  42. Arnalsteen LC, Alesina PF, Quiereux JL. Long-term results of less than total parathyroidectomy for hyperparathyroidism in multiple endocrine neoplasia type 1. Surgery. 2002;132(6):1119–24. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  43. Dotzenrath C, Goretzki PE, Cupisti K, Yang Q, Simon D, Röher HD. Malignant endocrine tumors in patients with MEN 1 disease. Surgery. 2001;129(1):91–5. Clinical Review; Level 4.

    Article  CAS  PubMed  Google Scholar 

  44. Hellman P, Skogseid B, Oberg K, Juhlin C, Akerström G, Rastad J. Primary and reoperative parathyroid operations in hyperparathyroidism of multiple endocrine neoplasia type 1. Surgery. 1998;124(6):993–9. Clinical Review; Level 3; Grade A.

    Article  CAS  PubMed  Google Scholar 

  45. Elaraj DM, Skarulis MC, Libutti SK. Results of initial operation for hyperparathyroidism in patients with multiple endocrine neoplasia type 1. Surgery. 2003;134(6):858–64. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  46. Salmeron MD, Gonzalez JM, Sancho IJ. Causes and treatment of recurrent hyperparathyroidism after subtotal parathyroidectomy in the presence of multiple endocrine neoplasia 1. World J Surg. 2013;34(6):1325–31. Clinical Review; Level 3; Grade A.

    Article  Google Scholar 

  47. Lambert LA, Shapiro SE, Lee JE. Surgical treatment of hyperparathyroidism in patients with multiple endocrine neoplasia type 1. Arch Surg. 2005;140(4):374–82. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  48. Powell AC, Alexander HR, Pingpank JF. The utility of routine transcervical thymectomy for multiple endocrine neoplasia 1-related hyperparathyroidism. Surgery. 2008;144(6):878–83. Clinical Review; Level 4.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Tonelli F, Marcucci T, Fratini G, Tommasi MS, Falchetti A, Brandi ML. Is total parathyroidectomy the treatment of choice for hyperparathyroidism in multiple endocrine neoplasia type 1? Ann Surg. 2007;246(6):1075–82. Clinical Review; Level 4.

    Article  PubMed  Google Scholar 

  50. Feldman AL, Sharaf RN, Skarulis MC. Results of heterotopic parathyroid autotransplantation: a 13-year experience. Surgery. 1999;126(6):1042–8. Clinical Review; Level 3; Grade A.

    Article  CAS  PubMed  Google Scholar 

  51. Moline J, Eng C. Multiple endocrine neoplasia type 2: an overview. Genet Med. 2011;13(9):755–64. Clinical Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  52. Krampitz GW, Norton JA. RET gene mutations (genotype and phenotype) of multiple endocrine neoplasia type 2 and familial medullary thyroid carcinoma. Cancer. 2014;120(13):1920–31. Clinical Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  53. American Thyroid Association Guidelines Task Force, Kloos RT, Eng C, et al. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid. 2009;19(6):565–612. Clinical Review; Level 2; Grade A.

    Article  Google Scholar 

  54. Raue F, Kraimps JL, Dralle H. Primary hyperparathyroidism in multiple endocrine neoplasia type 2A. J Intern Med. 1995;238(4):369–73. Clinical Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  55. Kraimps JL, Denizot A, Carnaille B. Primary hyperparathyroidism in multiple endocrine neoplasia type IIa: retrospective French multicentric study. Groupe d’Etude des Tumeurs á Calcitonine (GETC, French Calcitonin Tumors Study Group), French Association of Endocrine Surgeons. World J Surg. 1996;20(7):808–12. Clinical Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  56. Mortenson MM, Evans DB, Lee JE. Parathyroid exploration in the reoperative neck: improved preoperative localization with 4D-computed tomography. J Am Coll Surg. 2008;206(5):888–95. Clinical Review; Level 4.

    Article  PubMed  Google Scholar 

  57. Cetani F, Pardi E, Borsari S, Marcocci C. Molecular pathogenesis of primary hyperparathyroidism. J Endo Invest. 2011;34(7 Suppl):35–9. Clinical Review; Level 2; Grade A.

    CAS  Google Scholar 

  58. Kassem M, Kruse TA, Wong FK, Larsson C, Teh BT. Familial isolated hyperparathyroidism as a variant of multiple endocrine neoplasia type 1 in a large Danish pedigree. J Clin Endo Metab. 2000;85(1):165–7. Population/Observational Study; Level 3; Grade A.

    CAS  Google Scholar 

  59. Haven CJ, Wong FK, van Dam EW. A genotypic and histopathological study of a large Dutch kindred with hyperparathyroidism-jaw tumor syndrome. J Clin Endo Metab. 2000;85(4):1449–54. Population/Observational Study; Level 3; Grade A.

    CAS  Google Scholar 

  60. Jackson CE, Norum RA, Boyd SB. Hereditary hyperparathyroidism and multiple ossifying jaw fibromas: a clinically and genetically distinct syndrome. Surgery. 1990;108(6):1006–12. Population/Observational Study; Level 4.

    CAS  PubMed  Google Scholar 

  61. Carpten JD, Robbins CM, Villablanca A. HRPT2, encoding parafibromin, is mutated in hyperparathyroidism-jaw tumor syndrome. Nat Genet. 2002;32(4):676–80. Population/Observational Study; Level 4.

    Article  CAS  PubMed  Google Scholar 

  62. Wei CH, Harari A. Parathyroid carcinoma: update and guidelines for management. Curr Treat Options Oncol. 2012;13(1):11–23. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  63. Pollak MR, Brown EM, Chou YH. Mutations in the human Ca(2+)-sensing receptor gene cause familial hypocalciuric hypercalcemia and neonatal severe hyperparathyroidism. Cell. 1993;75(7):1297–303. Basic Science; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  64. Marx SJ, Spiegel AM, Brown EM, Aurbach GD. Family studies in patients with primary parathyroid hyperplasia. Am J Med. 1977;62(5):698–706. Population/Observational Study; Level 4.

    Article  CAS  PubMed  Google Scholar 

  65. Christensen SE, Nissen PH, Vestergaard P, Mosekilde L. Familial hypocalciuric hypercalcaemia: a review. Curr Opin Endocrinol Diabetes Obes. 2011;18(6):359–70. Clinical Review; Level 3; Grade A.

    Article  CAS  PubMed  Google Scholar 

  66. Slatopolsky E, Finch J, Denda M. Phosphorus restriction prevents parathyroid gland growth. High phosphorus directly stimulates PTH secretion in vitro. J Clin Invest. 1996;97(11):2534–40. Population/Observational Study; Level 3; Grade A.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Fukumoto S, Yamashita T. FGF23 is a hormone-regulating phosphate metabolism—unique biological characteristics of FGF23. Bone. 2007;40(5):1190–5. Basic Science Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  68. Razzaque MS. FGF23-mediated regulation of systemic phosphate homeostasis: is Klotho an essential player? Am J Physiol Renal Physiol. 2009;296(3):F470–6. Basic Science Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  69. Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208–18. Basic Science Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  70. Oliveira TM, Frazão JM. Calciphylaxis: from the disease to the diseased. J Nephrol. 2015;28(5):531–40. Population/Observational Study; Level 3; Grade A.

    Article  CAS  PubMed  Google Scholar 

  71. Tominaga Y, Sato K, Tanaka Y, Numano M, Uchida K, Takagi H. Histopathology and pathophysiology of secondary hyperparathyroidism due to chronic renal failure. Clin Nephrol. 1995;44 Suppl 1:S42–7. Population/Observational Study; Level 4.

    PubMed  Google Scholar 

  72. Tominaga Y, Numano M, Tanaka Y, Uchida K, Takagi H. Surgical treatment of renal hyperparathyroidism. Semin Surg Oncol. 1997;13(2):87–96. Population/Observational Study; Level 4.

    Article  CAS  PubMed  Google Scholar 

  73. Fukuda N, Tanaka H, Tominaga Y, Fukagawa M, Kurokawa K, Seino Y. Decreased 1,25-dihydroxyvitamin D3 receptor density is associated with a more severe form of parathyroid hyperplasia in chronic uremic patients. J Clin Invest. 1993;92(3):1436–43. Population/Observational Study; Level 4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Gogusev J, Duchambon P, Hory B. Depressed expression of calcium receptor in parathyroid gland tissue of patients with hyperparathyroidism. Kidney Int. 1997;51(1):328–36. Population/Observational Study; Level 4.

    Article  CAS  PubMed  Google Scholar 

  75. National Kidney Founcation K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003;42(4 Suppl 3):S1–201. Population/Observational Study; Level 4.

    Google Scholar 

  76. Guideline Working Group JSFDT. Clinical practice guideline for the management of secondary hyperparathyroidism in chronic dialysis patients. Ther Apher Dial. 2008;12(6):514–25. Clinical Review; Level 4.

    Article  Google Scholar 

  77. Rothmund M, Wagner PK, Schark C. Subtotal parathyroidectomy versus total parathyroidectomy and autotransplantation in secondary hyperparathyroidism: a randomized trial. World J Surg. 1992;15(6):745–50. Clinical Investigation; Level 1; Grade B.

    Article  Google Scholar 

  78. Chen J, Zhou QY, Wang JD. Comparison between subtotal parathyroidectomy and total parathyroidectomy with autotransplantation for secondary hyperparathyroidism in patients with chronic renal failure: a meta-analysis. Horm Metab Res. 2015;47(9):643–51. Clinical Review; Level 2; Grade A.

    Article  CAS  PubMed  Google Scholar 

  79. Lorenz K, Ukkat J, Sekulla C, Gimm O, Brauckhoff M, Dralle H. Total parathyroidectomy without autotransplantation for renal hyperparathyroidism: experience with a qPTH-controlled protocol. World J Surg. 2006;30(5):743–51. Clinical Investigation; Level 2; Grade B.

    Article  PubMed  Google Scholar 

  80. Stracke S, Jehle PM, Sturm D. Clinical course after total parathyroidectomy without autotransplantation in patients with end-stage renal failure. Am J Kidney Dis. 1998;33(2):304–11. Clinical Investigation; Level 2; Grade B.

    Article  Google Scholar 

  81. Agarwal AK, Katz SD. Future directions in management of anemia in heart failure. Heart Fail Clin. 2010;6(3):385–95. Clinical Review; Level 4.

    Article  PubMed  Google Scholar 

  82. Jia X, Wang R, Zhang C, Cui M, Xu D. Long-term outcomes of total parathyroidectomy with or without autoimplantation for hyperparathyroidism in chronic kidney disease: a meta-analysis. Ther Apher Dial. 2015;19(5):477–85. Clinical Review; Level 4.

    Article  PubMed  Google Scholar 

  83. Chen HH, Lin CJ, Wu CJ. Chemical ablation of recurrent and persistent secondary hyperparathyroidism after subtotal parathyroidectomy. Ann Surg. 2011;253(4):786–90. Clin Investigation; Level 4.

    Article  PubMed  Google Scholar 

  84. Kovatcheva RD, Vlahov JD, Stoinov JI. High-intensity focused ultrasound (HIFU) treatment in uraemic secondary hyperparathyroidism. Nephrol Dial Transplant. 2012;27(1):76–80. Clinical Investigation; Level 4.

    Article  CAS  PubMed  Google Scholar 

  85. Koiwa F, Kakuta T, Tanaka R, Yumita S. Efficacy of percutaneous ethanol injection therapy (PEIT) is related to the number of parathyroid glands in haemodialysis patients with secondary hyperparathyroidism. Nephrol Dial Transplant. 2007;22(2):522–8. Clinical Investigation; Level 4.

    Article  CAS  PubMed  Google Scholar 

  86. Nakamura M, Marui Y, Ubara Y. Effects of percutaneous ethanol injection therapy on subsequent surgical parathyroidectomy. NDT Plus. 2008;(Suppl 3):iii39–ii41. Clinical Investigation; Level 2; Grade B.

    Google Scholar 

  87. López V, Toledo R, Sola E. Treatment with cinacalcet in 29 kidney transplant patients with persistent hyperparathyroidism. Transplant Proc. 2009;41(6):2394–5. Clinical Investigation; Level 2; Grade B.

    Article  PubMed  Google Scholar 

  88. Yang RL, Freeman K, Reinke CE. Tertiary hyperparathyroidism in kidney transplant recipients: characteristics of patients selected for different treatment strategies. Transplantation. 2012;94(1):70–6. Clinical Investigation; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  89. Schlosser K, Endres N, Celik I, Fendrich V, Rothmund M, Fernández ED. Surgical treatment of tertiary hyperparathyroidism: the choice of procedure matters! World J Surg. 2007;31(10):1947–53. Clinical Review; Level 3; Grade A.

    Article  PubMed  Google Scholar 

  90. Triponez F, Clark OH, Vanrenthergem Y, Evenepoel P. Surgical treatment of persistent hyperparathyroidism after renal transplantation. Ann Surg. 2008;248(1):18–30. Clinical Review; Level 2; Grade A.

    Article  PubMed  Google Scholar 

  91. Dewberry LK, Weber C, Sharma J. Near total parathyroidectomy is effective therapy for tertiary hyperparathyroidism. Am Surg. 2014;80(7):646–51. Clinical Investigation; Level 2; Grade B.

    PubMed  Google Scholar 

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Clayburgh, D., Shindo, M. (2017). Surgical Management of Known Multiglandular Parathyroid Disease. In: Stack, Jr., B., Bodenner, D. (eds) Medical and Surgical Treatment of Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26794-4_21

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