What is a Parathyroid Adenoma?
And adenoma is a benign (noncancerous) growth that appears on one or more parathyroid glands.
An adenoma causes the parathyroid gland to produce more parathyroid hormone than the body needs, a condition called primary iperparathyroidism. Too much parathyroid hormone disrupts the normal calcium balance in the body, which increases the amount of calcium in the bloodstream.
A similar but less common condition, called secondary hyperparathyroidismcan occur in case of chronic renal failure.
L’iperparathyroidism
Parathyroid glands: what they are and what they do
The parathyroid glands they are found in the neckaround the thyroid. Most people have four oval parathyroid glands and as big as a pea. The task of the parathyroid is to release theparathyroid hormonewhich helps manage how the body uses calcium.
The brain cellsThe heart, nerves, bones and digestive system all need calcium to function properly. The “communication” between the parathyroid and the bloodstream helps keep calcium at its normal level. Parathyroid hormone takes calcium from the bones and increases reabsorption by the kidneys and intestines to maintain normal blood flow levels.
The Thyroid
Parathyroid Adenoma: Symptoms
Too much calcium in the blood (hypercalcemia) can cause a number of symptoms e medical conditions including:
- Feeling tired and weak;
- Confusion, memory loss;
- Depression, irritability or mental confusion;
- Kidney stones;
- Bone and joint pain, osteoporosis, bone fractures;
- Abdominal pain, heartburn, nausea and vomiting;
- Constipation;
- General pain and discomfort without obvious cause;
- High blood pressure (hypertension);
- Increased urination.
You may not have symptoms or recognize them before they are detected through routine blood tests that your doctor may have ordered as part of your general health care.
Endocrinology in Auxologico
Parathyroid adenoma: the causes
Scientists don’t know the cause of most parathyroid adenomas. About 10% is thought to be passed down from parents (inherited). Even theradiation exposure of the head and neck by children or young adults may increase the risk of adenomas. It is thought that also the lack of calcium in the long term diet you increase the risk.
Primary hyperparathyroidism is the medical condition that results from the presence of adenomas. Hyperparathyroidism can be caused by one or more adenomasfour adenomas (a condition called hyperplasia) or cancer (which is very rare, less than 1% of all parathyroid cases).
A single parathyroid adenoma is the cause in up to 85% of cases, two adenomas cause 4%-5% of cases, and four adenomas cause 10%-12% of cases of hyperparathyroidism.
Parathyroid adenoma and complications
Untreated parathyroid adenomas cause increased blood calcium levels. An extremely large amount can cause:
- Irregular heartbeats (cardiac arrhythmia);
- parathyroid crisis (a clinical event in which a person experiences mental changes that can lead to nervous system failure and coma);
- Death.
Diagnosis of Parathyroid Adenomas
Parathyroid adenomas are usually discovered when a calcium level higher than normal presents itself in a blood test routine. Your doctor may also ask you if you are taking thiazide diuretics o lithium. These two drugs can increase the level of calcium in the blood. Your doctor then confirms the diagnosis of primary hyperparathyroidism with a test that shows higher-than-normal levels of parathyroid hormone in the blood.
It is important to understand that the parathyroid disease primary is diagnosed by examining only the calcium levels e parathyroid hormone. Whether or not you may have symptoms does not matter in terms of diagnosis.
Once the diagnosis is made, your doctor may prescribe other tests to gather more information and check for complications. These could include:
- a special kind of method imaging to determine whether there are one or more adenomas;
- a TAC to check for calcium deposits in the kidneys and urinary tract;
- bone densitometry to measure bone loss;
- and 24-hour urinalysis to measure the amount of calcium lost in the urine.
Thyroid and Parathyroid Ultrasound
Treatment of Parathyroid Adenomas
Il most common treatment it’s thesurgery per remove the gland (or the glands) enlarged. Surgery solves the problem up to 95% of the time.
If for health reasons you cannot undergo surgery, i drugs they may be the only option. The different medications do not reduce the extra amount of parathyroid hormone in the blood. Instead, they prevent the loss of calcium from bones. The hormone replacement therapy or other treatments for this condition must be taken for the rest of your life.
A prescription drug called cinacalcet (sensipar®) reduces both calcium and parathyroid hormone levels in people with chronic kidney disease (secondary hyperparathyroidism). Its use in primary hyperparathyroidism is still under study.
The General Surgery Unit
Parathyroid Adenoma: frequently asked questions
IF I HAVE NO SYMPTOMS, DO I NEED SURGERY?
L’surgery is the most common treatment for parathyroid adenoma, even if you don’t have it symptoms.
The removal of one or more parathyroid glands (paratiroidectomia) can make you feel better, improving the overall quality of your life. More importantly, parathyroidectomy can prevent osteoporosis and kidney stones.
IF I DECIDE TO HAVE SURGERY, WHAT SHOULD I EXPECT?
Several weeks before surgery, your surgeon will order tests to look for one or more overactive parathyroid glands. These tests may include:
- And’neck ultrasound;
- A scan that uses a drug called tc-sestamibi;
- Pet-choline.
If imaging identifies a particular parathyroid gland that has an adenoma, the surgeon will look for that particular gland first during surgery. However, all four parathyroid glands must be identified during the scan. This scan is very important in terms of planning the surgery. Even if no parathyroid gland is seen on imaging, the diagnosis remains and the surgeon will still recommend surgery.
WHICH SURGICAL INTERVENTIONS TO REMOVE PARATHYROID ADENOMAS?
One is practiced small incision in the front of the neck in general anesthesia.
All four parathyroid glands are inspected during surgery. The surgeon removes the abnormal parathyroid. If one or two abnormal parathyroid glands are found, they are removed, and the remaining normal parathyroid gland can maintain a normal calcium level.
If all four parathyroid glands are abnormal, then 3 1/2 of the glands are removed. A little about parathyroid tissue it must be left in the body to maintain normal calcium levels.
I parathyroid hormone levels are monitored during surgery. If all diseased parathyroid glands have been removed, the parathyroid hormone level should drop by at least 50%.
The parathyroid glands removed during surgery they will be supervised by a pathologist (frozen evaluation) to confirm that the parathyroid gland was indeed overactive.
Finding all four parathyroid glands during surgery provides the highest long-term cure rate.
IS IT POSSIBLE TO PREVENT PARATHYROID ADENOMA?
No, there is no way to prevent development of growths on the parathyroid glands.
Parathyroid Gland Removal: the benefits of surgery
- Greater bone density;
- Reduced risk of bone fractures;
- Reduced risk of kidney stones.
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