Once suspected, the location of the recurrence should be determined. Neck imaging with CT, MRI, or ultrasound is indicated. Chest radiograph is indicated, but a chest CT may reveal pulmonary metastases missed on plain radiograph. This concentration of experience may hasten our understanding of this rare disease. See complications outlined in Hyperparathyroidism .
Postoperative hypocalcemia can be severe because of bone hunger syndrome.
Recurrent nerve injury may be unavoidable in some cases because of direct invasion by the tumor. Recurrence and death are quite common. Disease will recur after the initial operation in more than two-thirds of patients. Recurrence may often be delayed, sometimes for more than 20 years. Discuss the prognosis associated with the disease and its relationship to hypercalcemia.