Parathyroid Growths

What is a parathyroid gland growth?
Occasionally a benign or malignant growth of the parathyroid gland may occur because of a change in the cellular makeup of the parathyroid gland cells. The reason for a growth in the parathyroid gland is not always clear. There are several variations of abnormal growth of the parathyroid gland. Commonly in patients who undergo dialysis but also in numerous other patients, there is an abnormal enlargement of all four of the parathyroid glands located behind the thyroid gland. There is an overproduction of the hormone released by this gland, the parathyroid hormone which leads to release of calcium from the bones into the blood stream leading to high levels of calcium in the blood.

Alternatively, a benign growth called an adenoma which can be present in one or more of the parathyroid glands may be present. This type of growth although not a cancer can over produce PTH and cause dangerously high levels of calcium in the blood. Finally and less commonly, a cancerous lesion of the parathyroid gland may form usually without any known cause although more commonly after exposure to some type of radiation.

How is the diagnosis of a parathyroid growth made?
A routine blood test that detects high levels of calcium in the blood will normally prompt your physician to test for phosphorus and parathyroid hormone levels (PTH) as well as Vitamin D. All these factors are related to the metabolism of Calcium in the body. Additional blood tests and a 24 hour collection of urine may also be ordered at this point to determine how much calcium is being removed from the body.

Under certain circumstances depending on the levels of calcium, PTH, the presence of kidney stones, age younger than 50, the effect of removing calcium from the bones making them brittle etc. your doctor may feel that surgery is the best option.

Some imaging procedures such as an ultrasound may be performed or more importantly a physiologic scan called a sestamibi scan may be ordered. In a sestamibi scan, the parathyroid gland or glands that over produce the parathyroid hormone (PTH) can be clearly visualized. This test can help determine whether one or more of the parathyroid glands should be surgically removed.

The removal of one or more of the parathyroid glands is called a parathyroidectomy.

In a parathyroidectomy procedure a small horizontal incision is created just under the Adam’s apple to get access to the parathyroid glands. Parathyroidectomy is recommended when the parathyroid glands produce excessive amounts of parathyroid hormone (hyperparathyroidism). After surgery, complete healing without complications usually occurs within 4 weeks. The long term outlook is excellent.