Parathyroid adenoma

Do you get fatigued very easily and find yourself having fractures quite often? It could be that you are suffering from Parathyroid adenoma. Read and know more about the incidence, causes, symptoms, diagnosis and treatment of this condition.

Parathyroid adenoma Definition

It is a condition in which one of the four parathyroid glands increases in size and produces parathyroid hormone (PTH) in excess. It is characterized by the formation of a benign tumor in the gland.

Parathyroid glands that are located in the neck, produce PTH and are endocrine in nature. The major function of this hormone is to regulate and maintain the calcium level of the body within a very narrow range. In this condition, the parathyroid glands are not able to maintain normal levels of calcium in blood, causing very serious consequences. The excess PTH circulates in the bloodstream and releases calcium from the bones into the blood. This over activity of the parathyroid glands is known as Hyperparathyroidism or Parathyroid disease.

Parathyroid adenoma Incidence

Women who are above 60 years of age have the highest possibility of developing this benign state. This condition usually prevails in menopausal patients. Production of estrogen, a hormone responsible for regulation of PTH, gradually drops in these patients. This further aggravates the condition.

Parathyroid adenoma Symptoms

Picture of Parathyroid adenoma

Picture 1 – Parathyroid adenoma

It is considered as an asymptomatic disorder, owing to the absence of any visual symptoms. In most cases, patients do not realize the presence of this condition. It is usually discovered during routine blood tests conducted for detecting other medical conditions with similar symptoms.

Bone fractures

During hyperparathyroidism, bones constantly release calcium into the blood resulting in bone density loss. This usually occurs in patients with Osteoporosis who suffer from very fragile bones. In this condition, any mild trauma or stress can easily damage the bones and patients are always at a higher risk for a minor or major fracture.

Confusion

Patients may often feel disoriented and irritated. They may exhibit unusual behavior and often act aggressively. Some patients may also develop dementia or memory loss.

Constipation

Over activity of the parathyroid glands increases the calcium levels in the blood, causing infrequent bowel movements.

Kidney stones

Elevated levels of blood calcium may lead to development of kidney stones. The major function of the kidney is to filter and clean the blood. Constant filtering of large amounts of blood calcium results in excess deposition of the mineral within the renal tubules of the kidney. This leads to kidney stone formation.

Fatigue

Patients undergo chronic tiredness and lethargy, owing to deposition of calcium on the muscles joint. The body gets exhausted very easily and performing routine activities may become challenging.

Loss of appetite

High levels of calcium may cause weight loss by inhibiting the activity of fat cells and breaking down more fat through a process called lipolysis. The resulting fatty acids serve as a source of energy that reduces the need to eat.

Nausea

Some patients may experience acute discomfort in the abdominal region with an involuntary urge to vomit.

Parathyroid adenoma Causes

The exact cause behind the formation of such a benign tumor is not known. However there are certain risk factors that may give rise to this condition.

Heredity

It is often considered to be a inherited condition due to passing of traits from parents to offspring.

Radiation exposure

Long-term exposure of the head or neck to moderate doses of radiation can lead to formation of tumor. Nuclear power plant accidents and cosmic rays are some of the common sources from where harmful radiations are released.

Parathyroid adenoma Diagnosis

Some of the extensively used diagnostic tests for this disorder are:

Blood test

It is a primary diagnostic test conducted to detect the levels of Parathyroid hormone and calcium in the blood. The amount of these two substances is generally higher in patients with Parathyroid adenoma.

Urine test

Excess amount of calcium in the body is generally passed out through urine. Urine test is a 24-hour examination that can easily monitor calcium release through urine. It may also help in assessing the formation of kidney stones due to increased levels of calcium.

Bone densitometry

It is an enhanced form of X-ray that helps determine Osteoporosis (a disorder that involves a gradual loss of calcium from the bones due to over activity of PTH). In this procedure, the bone mineral density (BMD), representing the amount of bone in the body is measured. Patients suffering from this disorder have a low BMD, which indicates a higher risk of fractures. Bones that are usually tested the most are located in the spine, hips and forearm.

Kidney test

Standard x-rays of the kidneys can detect the presence of calcium stones. This is a very quick and viable technique to monitor the growth of a kidney stone. The stones generally appear white on the x-ray images that are obtained after the test.

CT Scans

Computerized tomography (CT) scan is an imaging procedure that combines a series of X-ray views and computer processing to create cross-sectional images of the kidney for detecting any stones.

Ultrasound

Ultrasound imaging of the kidneys can also help in detecting formation of any stones that blocks the outflow of urine. Calcium deposits harden the urinary tract and obstruct urination. Ultrasound is highly useful in cases where x-rays or CT scans are discouraged or do not yield any result.

Sestamibi neck scan

It is a nuclear medicine procedure that uses a radiopharmaceutical drug known as Tc99m to identify overactive parathyroid gland. The affected gland absorbs the gamma radiation that is emitted from the drug rapidly and is captured by a gamma camera. The images that are obtained after the scan show a brighter and swollen parathyroid gland compared to the other three glands which are normal.

Magnetic resonance imaging (MRI) of the neck

This particular imaging test helps detect in the Parathyroid gland the presence of tumor that appears dark in contrast to the adjacent tissues of the neck.

Parathyroid adenoma Treatment

The treatment or this disease involves:

Image of Parathyroid adenoma

Picture 2 – Parathyroid adenoma Image

Parathyroidectomy

It is a surgical removal of the benign tumor from the affected parathyroid gland. In severe cases, the affected gland may also be removed completely from the body in order to prevent excessive production of PTH. Sestamibi scanning is used as a preoperative method to identify the location of the glands. In this procedure, an incision is initially done in the neck under the Adam’s apple (protrusion). This is followed by removal of the overactive parathyroid gland or tumor. Endoscopic parathyroidectomy is a non-invasive form of this surgical procedure where an endoscope is inserted into the neck for removal of the benign tumor.

Medication

Calcimimetic is a drug that mimics calcium circulating in the blood. Presence of this drug in the blood may prevent the parathyroid glands from releasing excess PTH. Patients are often administered bisphosphonates that prevents the loss of calcium from the bones that normally occurs during osteoporosis.

Estrogen replacement therapy (ERT)

Regulation of PTH is normally controlled by estrogen, a female steroid hormone required for menstruation and reproduction. However, in this disorder, most number of women undergo menopause, due to which there is decreased level of estrogen in the body. ERT is a hormonal replacement procedure where estrogen is administered to the patients in form of an oral pill, cream or gel. The estrogen level in the body increases in this way, inhibiting loss of calcium from the bones.

Significant developments have been observed in both medical and surgical treatments of parathyroid adenoma.

Parathyroid adenoma is not a fatal condition and is completely curable if diagnosis is done at an early stage. If you suspect yourself to be experiencing the symptoms of this disorder, immediately get in touch with a doctor.

References:

http://emedicine.medscape.com/article/384024-overview

http://www.britannica.com/EBchecked/topic/443325/parathyroid-adenoma

http://en.wikipedia.org/wiki/Parathyroid_adenoma

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002170/

 

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