Introduction

Over-activation of the parathyroid glands and excessive secretion of parathyroid hormone (PTH) can cause primary hyperparathyroidism (PHPT), which is characterized by hypercalcaemia with high or inappropriately normal PTH concentrations. PHPT might present high normal or even normal calcium (Ca) levels (normocalcemic hyperparathyroidism)1. Approximately 80% of patients with single benign parathyroid adenoma are considered to be the most common cause of PHPT, while 15-20% of PHPT has the multiglandular disease2. The majority of PHPT patients, nearly 70-80%, are asymptomatic and diagnosed in routine blood tests. On the other hand, symptomatic patients display osteoporosis or neuromuscular changes (weakness, cognitive changes, and fatigue), and nephrolithiasis3. According to the guidelines in the 4th International Workshop, the definitive treatment for PHPT is still the surgical method 4. In recent years, thermal ablation methods involving laser, radiofrequency, and particularly microwave ablation (MWA) have been offering a good alternative for the treatment of patients with hyperparathyroidism, having surgical treatment risk or refusing the surgery. The main purpose of these techniques is thermal necrotizing of the parathyroid adenoma5–7. Compared to surgery, these procedures have some advantages such as being less invasive, repeatable, and having a fast recovery time 8. Indeed, MWA is a commonly used thermal ablation method and exhibited promising clinical results. Previous studies have shown that the applicability of MWA is a safe and an effective in treating hyperparathyroidism 5,9,10. The MWA procedure is mostly used in secondary hyperparathyroidism; however, a little attention has been paid to the patients with PHPT11–15. The present paper investigates the safety and efficacy of MWA in patients with PHPT caused by parathyroid adenoma.