Parathyroid adenoma

Definition

A parathyroid adenoma is a noncancerous (benign) tumor of the parathyroid glands, which are located in the neck.

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 bone.

Parathyroid adenomas can be due to a genetic problem. Parathyroid adenomas are the most common cause of hyperparathyroidism (overactive parathyroid glands), which leads to increased blood calcium levels.

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

Symptoms

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

Symptoms that may occur include:

• Confusion
• Constipation
• Lethargy
• Muscle pain
• Nausea

Exams and Tests

Blood tests are done to check the levels of parathyroid hormone, calcium, phosphorus, and vitamin D.

A 24-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 (may show swelling of the parathyroid glands)

Treatment

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

Outlook (Prognosis)

The 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)

When to Contact a Medical Professional

Call your health care provider if you have symptoms of this condition.

References

Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008:chap. 266.

Bringhurst FR, Demay MB, Kronenberg HM. Disorders of mineral metabolism. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008:chap. 27.

Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 253.

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