Parathyroid adenoma
A parathyroid adenoma is a noncancerous (benign) tumor of the parathyroid glands. The parathyroid glands are located in the neck, near or attached to the back side of the thyroid gland.
Causes
The parathyroid glands in the neck help control calcium absorption, use, and removal by the body. They do this by producing parathyroid hormone, or PTH. PTH helps control calcium, phosphorus, and vitamin D levels in the blood and bone. It is important for healthy bones.
Parathyroid adenomas are common. Most parathyroid adenomas do not have an identified cause. Sometimes a genetic problem is the cause. This is more common if the diagnosis is made when you are young.
Parathyroid adenomas may occur in people without a family history of the disease, or as part of 3 inherited syndromes:
- Multiple endocrine neoplasia (MEN) I
Multiple endocrine neoplasia (MEN) I
Multiple endocrine neoplasia (MEN) type I is a disease in which one or more of the endocrine glands are overactive or forms a tumor. It is passed do...
Read Article Now Book Mark Article - Multiple endocrine neoplasia (MEN) IIA
Multiple endocrine neoplasia (MEN) IIA
Multiple endocrine neoplasia, type II (MEN II) is a disorder passed down through families in which one or more of the endocrine glands are overactive...
Read Article Now Book Mark Article - Isolated familial hyperparathyroidism
In people with an inherited syndrome, a changed (mutated) gene is passed down through the family. You only need to get the gene from one parent to develop the condition.
- In MEN I, problems in the parathyroid glands occur, as well as tumors in the pituitary gland and pancreas.
- In MEN IIA, overactivity of the parathyroid glands occurs, along with tumors in the adrenal or thyroid gland.
Conditions that stimulate the parathyroid glands to get bigger can also cause an adenoma. These include:
- Genetic disorders
- Taking the drug lithium
- Chronic kidney disease
Women over age 60 have the highest risk for developing this condition. Radiation to the head or neck also increases the risk.
Symptoms
Many people have no symptoms. The condition is often discovered when blood tests are done for another medical reason.
Parathyroid adenomas are the most common cause of hyperparathyroidism (overactive parathyroid glands), which leads to an increased blood calcium level. Symptoms may include any of the following:
- Confusion
- Constipation
-
Lack of energy (lethargy)
Lethargy
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Muscle pain
- Nausea or decreased appetite
- Urinating more often at night
- Weak bones or fractures
Exams and Tests
Blood tests may be done to check levels of:
- PTH
PTH
The PTH test measures the level of parathyroid hormone in the blood. PTH stands for parathyroid hormone. It is a protein hormone released by the par...
Read Article Now Book Mark Article - Calcium
Calcium
The calcium blood test measures the level of calcium in the blood. This article discusses the test to measure the total amount of calcium in your blo...
Read Article Now Book Mark Article - Kidney function (Creatinine, BUN)
- Magnesium
- Phosphorus
Phosphorus
The phosphorus blood test measures the amount of phosphate in the blood.
Read Article Now Book Mark Article - Vitamin D
Vitamin D
The 25-hydroxy vitamin D test is the most accurate way to measure how much vitamin D is in your body. Vitamin D helps control calcium and phosphate l...
Read Article Now Book Mark Article
A 24-hour urine test may be done to check for increased calcium in the urine.
Other tests include:
- Bone density exam
Bone density exam
A bone mineral density (BMD) test measures how much calcium and other types of minerals are in an area of your bone. This test helps your health care...
Read Article Now Book Mark Article - Kidney ultrasound or CT scan (may show kidney stones or calcification)
- Kidney x-rays (may show kidney stones)
- MRI
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
Read Article Now Book Mark Article - Neck ultrasound
- Sestamibi neck scan (to identify the location of the parathyroid adenoma)
Treatment
Surgery is the most common treatment, and it often cures the condition. But, some people choose to only have regular checkups with their health care provider if the condition is mild.
To help improve the condition, your provider may ask you to stop taking calcium and vitamin D supplements. Women who have gone through menopause may want to discuss treatment with estrogen or other medicines to prevent bone loss.
Outlook (Prognosis)
When treated, outlook is generally good.
Possible Complications
Osteoporosis and the increased risk for bone fractures is the most common concern.
Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
Read Article Now Book Mark ArticleOther complications are less common, but may include:
- Nephrocalcinosis (calcium deposits in the kidneys that can reduce kidney function)
Nephrocalcinosis
Nephrocalcinosis is a disorder in which there is too much calcium deposited in the kidneys. It is common in premature babies.
Read Article Now Book Mark Article - Osteitis fibrosa (softened, weak areas in the bones)
Osteitis fibrosa
Osteitis fibrosa is a complication of hyperparathyroidism, a condition in which overactive parathyroid glands cause certain bones to become abnormall...
Read Article Now Book Mark Article
Complications from surgery include:
- Damage to a nerve that controls your voice
- Damage to the parathyroid glands, which causes hypoparathyroidism (lack of enough parathyroid hormone) and low calcium level
Hypoparathyroidism
Hypoparathyroidism is a disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH).
Read Article Now Book Mark Article
When to Contact a Medical Professional
Call your provider if you have symptoms of this condition.
Reviewed By
Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Reid LM, Kamani D, Randolph GW. Management of parathyroid disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 123.
Silverberg SJ, Bilezikian JP. Primary hyperparathyroidism. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 63.
Thakker RV. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 232.