Biopsy should always occur at the antihilar area of the glands and be done with small scissors to avoid crushing the gland. Parathyroid tissue sinks in Saline, whereas fat floats. Wide en bloc resection is the treatment of choice with avoidance of spillage. Chemo and radiotherapy are considered ineffective. Surgery and extent of disease at presentation determine survival.
Death is usually due to complications of hypercalcemia.
MC sites resp. If the missing gland is the only tissue left it should be auto-trtansplanted into the arm. More likely after second explorations and if all glands were biopsied Pts. Should be placed on oral Calcium when feasible Magnesium Deficiency impairs secreation of PTH, always detect and replace when necessary. Gradually decrease IV CaGluconate 4.