Enlarged parathyroid glands discovered in normocalcemic patients during thyroid surgery

Background This is a retrospective study analyzing data of normocalcemic patients with enlarged parathyroid glands discovered during thyroid surgery and comparing it with data of patients operated on for proved primary hyperparathyroidism. Methods The records of patients with enlarged parathyroid glands (group 1) and those with primary hyperparathyroidism (group 2) were reviewed. Results There were 11 patients in group 1 and 123 patients in group 2. Enlarged parathyroid glands identified at thyroid surgery were lighter and developed in younger patients. Biochemistry and pathology revealed that these were less hyperfunctioning. Sex, number of diseased glands per patient, and cell type were not statistically different between the 2 groups. Conclusions Enlarged parathyroid glands discovered at the time of surgery are mildly hyperfunctioning. They may represent an early pathologic stage responsible for overt primary hyperparathyroidism. We recommend removal of enlarged parathyroid glands found during thyroid operation in normocalcemic patients as long as at least 1 normal parathyroid gland remains.