Patients with symptomatic disease or this who meet surgery criteria will be proposed to undergo a selective PTX. Surgery criteria are generally as follows: a serum calcium concentration >1.0 mg/dL above the upper limit of normal, creatinine clearance <60 mL/min, BMD >2.5 standard deviation below standard reference values for sex-matched peak bone mass at any site (T-score <-2.5), age <50 years old.