Lab Value


In a 65-year-old woman with primary hyperparathyroidism, which of the following is a contraindication to minimally invasive parathyroidectomy?

Bilateral cervical exploration is the gold standard in the treatment of primary hyperparathyroidism, though minimally invasive parathyroidectomy has gained widespread acceptance. If preoperative imaging is not possible or does not localize a parathyroid adenoma, a bilateral exploration should be performed. Although a history of ionizing radiation to the head/neck region does increase the incidence of multigland disease, a minimally invasive parathyroidectomy is acceptable if imaging successfully localizes the enlarged gland and intraoperative PTH confirms biochemical cure. Amiodarone does not induce hyperparathyroidism but may cause thyroiditis.