Multiglandular Parathyroid Disease and MEN Syndromes

  • Peter Langer
  • Detlef K. Bartsch
  • Matthias Rothmund

24.9 Summary

Parathyroid surgery in the setting of familial disorders resulting in multiglandular disease is challenging for the endocrine surgeon. The aim of surgery is to gain eucalcemia for a long time without producing hypocalcemia. Since the syndromes are rare, sufficient data are lacking in most diseases. MEN1-HPTH should be treated with subtotal or total PTX with autotransplantation. Surgery in MEN2A has to be more tailored to the individual patient and subtotal PTX, total PTX and autotransplantation as well as excision of grossly enlarged glands might be alternatives depending on the patient’s history of the disease. The surgical approach to patients with HPTH-JTS is the same as to MEN2A-HPTH. Nevertheless radical surgery may be required in this special setting, since the incidence of parathyroid carcinoma is comparably high in these patients.

Cryopreservation of parathyroid tissue is mandatory in all cases of familial HPTH. The role of minimally invasive parathyroid surgery in familial HPTH is limited and should only be performed in redo cases combined with intraoperative PTH measurements.

Patients with FHH do not benefit from parathyroid surgery whereas infants with neonatal severe HPTH need to be operated on and total parathyroidectomy performed.


Primary Hyperparathyroidism Medullary Thyroid Carcinoma Parathyroid Carcinoma Parathyroid Tissue Total Parathyroidectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2007

Authors and Affiliations

  • Peter Langer
    • 1
  • Detlef K. Bartsch
    • 2
  • Matthias Rothmund
    • 2
  1. 1.Department of SurgeryPhilipps-University HospitalMarburgGermany
  2. 2.Department of SurgeryPhilipps-UniversityMarburgGermany

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