Parathyroid adenoma

Definition

Parathyroid adenomas are benign (noncancerous) tumors of the parathyroid glands, which are located in the neck and help regulate calcium metabolism.

Causes, incidence, and risk factors

This tumor is the most common cause of hyperparathyroidism, which causes elevated levels of calcium in the blood (hypercalcemia). Parathyroid adenomas are generally caused by genetic mutations.

Women over 60 are at highest risk. If your head or neck has been exposed to radiation, this can also increase risk.

Symptoms

Many people have no symptoms. The condition is often discovered in the course of treatment for another problem or is identified via tests done as part of a general physical.

Symptoms that may occur include the following:

• Lethargy
  
• nausea
  
• Constipation
  
• myalgias (muscle pains)
  
• Kidney stones
  
• bone fractures
  

Signs and tests

Signs may include:

• fractures
  
• renal colic
  

Tests may show:

• elevated serum calcium
  
• low serum phosphorus
  
• elevated intact PTH
  
• elevated serum chloride
  
• low serum bicarbonate
  
• elevated 24-hour urine calcium
  
• low bone mineral density
  
• abnormal X-rays (may show Kidney stones)
  
• renal stones on ultrasound or CT
  
• MRI or Tc-thallium neck scan showing enlarged parathyroid
  

Treatment
Surgery is the most common treatment. However, many patients with mild hyperparathyroidism are not treated but are monitored for escalation of symptoms. Some postmenopausal women may consider estrogen replacement, which can help relieve symptoms and prevent bone loss.

Expectations (prognosis)