Treatment of Parathyroid Adenoma in Multiple Endocrine Neoplasia Type 1

Primary hyperparathyroidism occurring in the context of multiple endocrine neoplasia type 1 (MEN1) represents a distinct clinical entity. The genetic and multi-glandular nature of MEN1 shapes the treatment approach differently from sporadic parathyroid disease.

Clinical scenario: Parathyroid adenoma arising as part of multiple endocrine neoplasia type 1 (MEN1)–associated primary hyperparathyroidism — a setting in which parathyroid involvement occurs within a broader hereditary endocrine syndrome.

Management in this setting involves a specific surgical intervention as the index operation. The precise operative scope, decision criteria, and follow-up strategy are outlined in the full protocol.

Clinical goal: Reestablishment of normal calcium homeostasis (eucalcemia).

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References

DOI: 10.1001/jamasurg.2016.2310

In patients with multiple endocrine neoplasia type 1–associated pHPT, subtotal parathyroidectomy is recommended as the index operation.

Cure after parathyroidectomy is defined as the reestablishment of normal calcium homeostasis lasting a minimum of 6 months.

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