Parathyroid Tumors

Parathyroid adenomas are benign tumors that secrete excessive amounts of PTH, leading to hyperparathyroidism Hyperparathyroidism Hyperparathyroidism occurs when overactive parathyroid glands cause levels of parathyroid hormone (PTH) in the blood to become elevated. An elevated PTH level then leads to a high level of calcium... read more . In addition to hypercalcemia, hyperparathyroidism causes

Parathyroid adenomas usually occur as isolated solitary tumors, and they are more common among older women. However, multiple parathyroid adenomas may occur in hereditary syndromes in people with multiple endocrine neoplasia Multiple Endocrine Neoplasia Syndromes (MEN) Multiple endocrine neoplasia syndromes are rare, inherited disorders in which several endocrine glands develop noncancerous (benign) or cancerous (malignant) tumors or grow excessively without... read more (MEN). MEN syndromes are rare inherited disorders in which several endocrine glands (those that release hormones directly into the bloodstream) develop benign (noncancerous) or malignant (cancerous) tumors. Alternatively, the endocrine glands may simply become enlarged without forming tumors.

Most parathyroid adenomas do not cause symptoms and are identified when blood tests done for another reason reveal high calcium levels. If symptoms occur, they are usually due to hypercalcemia or kidney stones Stones in the Urinary Tract Stones (calculi) are hard masses that form in the urinary tract and may cause pain, bleeding, or an infection or block of the flow of urine. Tiny stones may cause no symptoms, but larger stones... read more .

Doctors diagnose hyperparathyroidism based on elevated PTH levels in people with hypercalcemia. If the doctor finds elevated levels of PTH, further tests are needed, including

Doctors sometimes use various imaging studies, such as high-resolution computed tomography (CT) with or without biopsy, magnetic resonance imaging (MRI), high-resolution ultrasonography, or angiography to identify the adenoma before surgery.

Treatment is usually surgical removal of the affected parathyroid gland. For people with only mildly elevated calcium levels who do not have symptoms or complications, doctors may instead monitor them regularly (called active surveillance).

Occasionally, doctors prescribe medications such as cinacalcet or etelcalcetide to decrease secretion of PTH.

Parathyroid cancers are rare.

Risk factors for parathyroid cancer include

The hyperparathyroidism and hypercalcemia due to parathyroid cancer are more severe than those due to parathyroid adenomas.

Symptoms are due to hypercalcemia Hypercalcemia (High Level of Calcium in the Blood) In hypercalcemia, the level of calcium in blood is too high. A high calcium level may result from a problem with the parathyroid glands, as well as from diet, cancer, or disorders affecting... read more and include weakness and fatigue, constipation, loss of appetite, poor concentration, memory loss, confusion, and increased urination.

Doctors diagnose parathyroid cancers with blood tests to detect elevated levels of PTH and with imaging tests to locate tumors.

Parathyroid cancers are usually removed surgically. Sometimes radiation therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle (linear) accelerator. Radiation preferentially... read more and/or chemotherapy Chemotherapy and Other Systemic Cancer Treatments Systemic treatments are those that have effects throughout the body rather than being applied directly to the cancer. Chemotherapy is a form of systemic treatment that uses drugs to kill cancer... read more are also needed.

Parathyroid cancers usually grow slowly. If the surgeon is able to cleanly remove the entire gland, long-term survival without recurrence is likely. Any cancer that does recur usually grows slowly and spreads locally in the neck. Occasionally, parathyroid cancers metastasize (spread to other areas of the body).