{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:45:44Z","timestamp":1782456344763,"version":"3.54.5"},"reference-count":73,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Hyperparathyroidism (HPT) is a complex endocrine disorder characterized by the dysregulated secretion of parathyroid hormone (PTH), leading to significant disruptions in calcium and phosphate homeostasis. This review provides a comprehensive analysis of the condition, beginning with the distinct clinical and biochemical profiles of its primary, secondary, and tertiary forms. It critically examines the evolving diagnostic pathways and the refined indications for surgical intervention, which remains the only curative treatment for primary HPT and a crucial therapy for advanced secondary and tertiary disease. Central to the discussion is a detailed exploration of modern surgical strategies, highlighting the paradigm shift from traditional bilateral neck exploration to precision-focused, minimally invasive parathyroidectomy, enabled by advanced preoperative localization and intraoperative PTH monitoring. The review further considers outcomes, postoperative management, and emerging techniques, including remote-access endoscopic approaches. By synthesizing current evidence and guidelines, this work aims to delineate a holistic framework for the effective management of HPT, from accurate diagnosis through to the selection and execution of the optimal surgical treatment strategy.<\/jats:p>","DOI":"10.3389\/fendo.2026.1809252","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:46:09Z","timestamp":1782452769000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hyperparathyroidism: current concepts in diagnosis and surgical treatment"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhiyuan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Thyroid Disease Diagnosis and Treatment, Qingdao Municipal Hospital (Qingdao Hospital of Rehabilitation University)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianqiang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Thyroid Disease Diagnosis and Treatment, Qingdao Municipal Hospital (Qingdao Hospital of Rehabilitation University)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.2310","article-title":"The American association of endocrine surgeons guidelines for definitive management of primary hyperparathyroidism","volume":"151","author":"Wilhelm","year":"2016","journal-title":"JAMA Surg"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-021-02173-1","article-title":"Management of primary and renal hyperparathyroidism: guidelines from the German Association of Endocrine Surgeons (CAEK)","volume":"406","author":"Weber","year":"2021","journal-title":"Langenbecks Arch Surg"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2000","article-title":"The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the fourth international workshop","volume":"99","author":"Udelsman","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-4022","article-title":"Incidence and prevalence of primary hyperparathyroidism in a racially mixed population","volume":"98","author":"Yeh","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1414","article-title":"Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the fourth international workshop","volume":"99","author":"Eastell","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/s0889-8529(05)70146-8","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian","year":"2018","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4677","article-title":"Evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the Fifth International Workshop","volume":"37","author":"Bilezikian","year":"2022","journal-title":"J Bone Miner Res"},{"key":"B8","doi-asserted-by":"crossref","DOI":"10.1016\/j.surg.2018.04.090","article-title":"Parathyroidectomy versus Cinacalcet in the management of tertiary hyperparathyroidism: surgery improves renal transplant allograft survival","volume":"165","author":"Finnerty","year":"2019","journal-title":"Surgery"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02304","article-title":"Selective parathyroid venous sampling in patients with complicated hyperparathyroidism","volume":"155","author":"Ogilvie","year":"2006","journal-title":"Eur J Endocrinol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3803\/enm.2019.34.4.327","article-title":"Intraoperative parathyroid hormone monitoring in the surgical management of sporadic primary hyperparathyroidism","volume":"34","author":"Khan","year":"2019","journal-title":"Endocrinol Metab (Seoul)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.2.186","article-title":"Measurement of intraoperative parathyroid hormone predicts long-term operative success","volume":"137","author":"Trinh","year":"2002","journal-title":"Arch Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00198-016-3716-2","article-title":"Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. 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