Parathyroid hyperplasia

Last revised by Mostafa El-Feky on 27 Dec 2022

Parathyroid hyperplasia is the diffuse enlargement of the parathyroid glands and is a less common cause of primary hyperparathyroidism

There is a female predilection (M:F = 1:3). 

Most commonly an incidental finding of hypercalcemia in asymptomatic patients. 

In ~50% of cases, there is asymmetric enlargement of the parathyroid glands. 

  • primary parathyroid hyperplasia
    • sporadic (80%): associated with exposure to radiation and lithium
    • familial (20%): associated with MEN 1 and MEN 2a
  • secondary parathyroid hyperplasia
    • renal failure

Nuclear medicine (Tc-99m MIBI) is the current modality of choice. 4DCT has been shown to be specific but not sensitive. 

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Cases and figures

  • Case 1
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  • Case 2
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