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Parathyroid adenoma

Hyperparathyroidism - parathryoid adenoma; Overactive parathyroid gland - parathyroid adenoma

 

A parathyroid adenoma is a noncancerous (benign) tumor of the parathyroid glands. The parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland.

Causes

 

The parathyroid glands in the neck help control calcium use and removal by the body. They do this by producing parathyroid hormone, or PTH. PTH helps control calcium, phosphorus, and vitamin D levels in the blood and is important for healthy bones.

Parathyroid adenoma can be due to a genetic problem. It may also be caused by radiation to the neck or taking the drug lithium.

Women over age 60 have the highest risk for developing this condition. Radiation to the head or neck also increases risk.

 

Symptoms

 

Many people have no symptoms. The condition is often discovered when blood tests are done for another medical reason.

Parathyroid adenomas are the most common cause of hyperparathyroidism (overactive parathyroid glands), which leads to an increased blood calcium level. Symptoms may include any of the following:

  • Confusion
  • Constipation
  • Lack of energy (lethargy)
  • Muscle pain
  • Nausea or decreased appetite
  • Urinating more often at night
  • Weak bones or fractures

 

Exams and Tests

 

Blood tests may be done to check levels of:

  • PTH
  • Calcium
  • Phosphorus
  • Vitamin D

A 24-hour urine test may be done to check for increased calcium in the urine.

Other tests include:

  • Bone density exam
  • Kidney ultrasound or CT scan (may show kidney stones)
  • Kidney x-rays (may show kidney stones)
  • MRI
  • Neck ultrasound
  • Sestamibi neck scan (to check for swelling of the parathyroid glands)

 

Treatment

 

Surgery is the most common treatment, and it often cures the condition. But, some people choose to only have regular checkups with their health care provider if the condition is mild.

To help improve the condition, your provider may ask you to stop taking calcium and vitamin D supplements. Women who have gone through menopause may want to discuss treatment with estrogen.

 

Outlook (Prognosis)

 

When treated, outlook is generally good.

 

Possible Complications

 

Osteoporosis and the increased risk for bone fractures is the most common concern.

Other complications are less common, but may include:

  • Nephrocalcinosis (calcium deposits in the kidneys that can reduce kidney function)
  • Osteitis fibrosa cystica (softened, weak areas in the bones)

Complications from surgery include:

  • Damage to a nerve that controls your voice
  • Damage to the parathyroid glands, which causes hypoparathyroidism (lack of enough parathyroid hormone) and low calcium level

 

When to Contact a Medical Professional

 

Call your provider if you have symptoms of this condition.

 

 

References

Silverberg SJ, Bilezikian JP. Primary hyperparathyroidism. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 63.

Thakker RV. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 245.

 
  • Endocrine glands

    Endocrine glands - illustration

    Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

    Endocrine glands

    illustration

  • Parathyroid glands

    Parathyroid glands - illustration

    The 4 parathyroid glands are located near or attached to the back side of the thyroid gland and produce pararthyroid hormone (PTH). Parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the blood and bone by maintaining a balance between the mineral levels in the blood and the bone.

    Parathyroid glands

    illustration

    • Endocrine glands

      Endocrine glands - illustration

      Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

      Endocrine glands

      illustration

    • Parathyroid glands

      Parathyroid glands - illustration

      The 4 parathyroid glands are located near or attached to the back side of the thyroid gland and produce pararthyroid hormone (PTH). Parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the blood and bone by maintaining a balance between the mineral levels in the blood and the bone.

      Parathyroid glands

      illustration

    Self Care

     

      Tests for Parathyroid adenoma

       

       

      Review Date: 5/2/2016

      Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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