Treatment Parathyroid adenoma abroad

Parathyroid adenoma is benign, usually not terminally dangerous tumor of the hormone-active parathyroid gland caused by over abundant production of parathyroid hormone. Patients with this disease may develop so-called hypercalcemia, which is an overabundant level of calcium in the body. Hypercalcemia may cause such disease of the bones as osteoporosis. It may also affect kidney, gastrointestinal tract and heart. All this may result later in gastric ulcer, pancreatitis or cardiovascular hypertension.

Parathyroid adenoma develops in parathyroid glands. These are little endocrine formations which are located in the vicinity to the thyroid gland. Typically, person has two pairs of parathyroid glands, which are called upper and lower parts of the glands, but in some cases there may be an extra pair, if thyroid gland is thickened. Parathyroid glands are responsible for producing parathyroid hormone, which regulates the calcium metabolism in the body.

If a person is diagnosed with parathyroid cancer, his/her parathyroid glands accumulate too much hormone, which results in increase of calcium level in blood. Parathyroid adenoma is more common in women, which occurs for them twice as often as for men. It can develop after 20 years of age.

Parathyroid adenoma symptoms

Ectopic parathyroid adenoma usually occurs if there was some kind of mutation in the production of parathyroid hormone. Mutation affects cells that are mostly responsible for the calcium transport from adenomas. Consequently mutated cells acquire an abnormal secretory activity, and they begin to multiply, transforming into malignant cells that develop parathyroid adenoma. Sometimes mutated cells do not become cancerous, but if the abnormality is not treated on time, risk of developing tumor becomes very high.

Normally parathyroid adenoma contains cysts.

Symptoms of parathyroid adenoma

Clinical manifestations of parathyroid adenomas can vary There are cardiovascular and gastrointestinal forms of hypercalcemia and they are manifested in different ways. Typical parathyroid adenoma symptoms are as follows:

  1. dizziness
  2. general loss of appetite
  3. evening nausea
  4. constipation
  5. pain in the bones
  6. muscle weakness
  7. memory loss 
  8. depression
  9. convulsions
  10. in rare cases coma

Almost all patients with parathyroid adenoma develop hypercalcemia in bones. That`s why patient with parathoid adenoma experience osteoporosis, problems with vertebrae, loss of teeth and hair.  Excess of calcium deposits in the heart muscle causes myocardial infarction.

If hypercalcemia affects kidneys, patients may develop kidney stones, which are the cause of nephrocalcinosis.

If the gastrointestinal tract was damaged by hypercalcemia patient may experience stomach or duodenal ulcer. Its most common manifestations are exacerbation, cholecystitis, pancreatitis which are accompanied by severe pain and vomiting.

Abnormalities in cardiovascular system during parathyroid adenoma are usually expressed as arterial hypertension and dysfunction of coronary arteries.

Generally, people with hypercalcium feel pain in the joints because they have unnecessary deposits of calcium salt in their bones. Their skin becomes dry and itchy, they start to lose hair and their mobility becomes restricted.

Diagnosis of parathyroid adenoma

Examination for the signs of adenomas includes general laboratory tests, which can determine the amount of parathyroid hormone in blood. Such tests also assess level of calcium and phosphorus in the thyroid gland. In order to determine if there actually is a tumor in the gland, doctors use X-ray examination, ultrasound and biopsy.

In order to fully examine patient with parathyroid adenoma symptoms, doctor may refer to endocrinologist, gastroenterologist, cardiologist, nephrologist and neurologist to evaluate if hypercalcium  is present in other organs.  .

It is mandatory to investigate levels of parathyroid hormone to make a valid conclusion and usually doctors use special bone markers that can assess the level of parathyroid hormone in the blood which is flowing from the thyroid gland.

To assess bone destruction severity doctor inspects the state of bones of the feet, hands, skull and torso. Condition of the digestive system is assessed by abdominal ultrasound or by endoscopy, when the camera is introducedinto the patient`s body.

Sometimes it may be difficult to diagnose the parathyroid adenoma, because its symptoms resemble multiple hormonal diseases, such as fibrous dysplasia and dysplasia of other joints.

Treatment of parathyroid adenoma

Parathyroid adenoma treatment usually requires surgical intervention with resection of the affected glands. In fact parathyroid adenoma surgery is the only treatment solution for this disease, because it can not be cured by chemotherapy or radiofrequency intervention. During the surgery both sides of neck are open and a doctor removes the glands tumor. During the surgery on the parathyroid glands, it is important to constantly examine all glands, monitor calcium  in blood level and check heart activity.

Before the surgical intervention patient has to undergo special preoperative stage which includes treatment of hypercalcemia and organs that were affected by the excessive amount of calcium in the body. During this preoperative stage patient needs to be on a special diet, which totally restricts calcium consumption with food. Since surgery is done on the neck, it is vital for the surgeon to preserve patient's voice, which requires great skills and proficiency.

If there are multiple parathyroid adenomas they all need to be removed.

What happens next?

After parathyroid treatment, the levels of calcium in the body need to be checked constantly. Typically after the removal of adenomas the circulation of calcium in the blood normalizes in the matter of 3-4 days. In some rare cases patient may get hypocalcemia, which requires further treatment. Usually it can be cured by special diet and drugs that help to control level calcium. After the surgery the bone structure can become too fragile. In order to restore it, patients take course of physiotherapy.


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