Asymptomatic Primary Hyperparathyroidism: Diagnostic Pitfalls and Surgical Intervention.

Primary hyperparathyroidism (PHPT) is a common disease, with a prevalence as high as 1 in 400 women and 1 in 1000 men, and most are asymptomatic. Patients with PHPT have hypercalcemia with inappropriately normal levels of parathyroid hormone. Parathyroidectomy is the only curative therapy, and the procedure has become more common and more safe. Among asymptomatic patients, parathyroidectomy halts the progression of disease, improves quality of life, and may decrease risk of fracture and adverse cardiovascular outcomes. Thus, surgery should be considered in all patients with asymptomatic PHPT who have minimal perioperative risk and sufficient life expectancy, regardless of chronologic age.