Parathyroid Adenoma

A parathyroid adenoma is a usually noncancerous growth in one of the small parathyroid glands behind the thyroid. The growth can make too much parathyroid hormone, which raises the level of calcium in the blood and causes primary hyperparathyroidism. Some people have no noticeable symptoms, and the condition is found during routine blood testing. The parathyroid hormone function is to help keep calcium levels balanced for healthy bones, muscles and nerves.

Parathyroid adenoma symptoms can vary depending on how high the calcium level is and how long it stays elevated. Many adenomas cause mild symptoms or are discovered unexpectedly during routine blood tests. When symptoms occur, they may affect the kidneys, bones, digestive system, muscles or mood.

Normally, parathyroid hormone helps maintain calcium balance by signaling the bones, kidneys and intestines to adjust how calcium is stored, removed and absorbed. In a parathyroid adenoma, abnormal cells release parathyroid hormone when the body does not need more of it. This excess hormone raises blood calcium and can lead to primary hyperparathyroidism. In most cases, the exact reason the cells begin growing abnormally is not known.

Parathyroid Adenoma vs. Thyroid Growth

The parathyroid glands sit behind the thyroid, but they are separate glands with different functions. A thyroid adenoma or thyroid nodule develops in thyroid tissue and does not mean that a parathyroid gland is abnormal. Imaging may show a growth near the thyroid, but laboratory tests are needed to help determine whether it is related to the parathyroid glands.

Having one of these risk factors does not mean that a person will develop a parathyroid adenoma. Many cases of parathyroid disease occur without an identifiable cause, and most listed factors cannot be changed or prevented.

Diagnosis usually begins with blood tests showing high calcium and a parathyroid hormone level that is high or not appropriately suppressed. Symptoms alone cannot confirm the condition because some people have few or no symptoms. Additional tests assess the effects on the kidneys and bones and help locate an abnormal gland if surgery is being considered.

Treatment depends on calcium levels, symptoms, complications, kidney and bone health, and whether surgery is suitable. For a functioning adenoma, surgery is the definitive treatment, while selected people may be monitored or treated medically when surgery is delayed or not appropriate.

Parathyroidectomy

Parathyroidectomy removes the overactive gland and is commonly recommended when calcium is significantly elevated or there are symptoms, kidney stones, reduced kidney function or bone complications. Preoperative imaging helps the surgeon plan the approach, and the surgeon may assess more than one gland when multiple-gland disease is suspected. Recovery is often short, but calcium and parathyroid hormone levels are monitored afterward because calcium can temporarily fall while the body adjusts.

Monitoring and medical treatment

Some people who do not meet surgical criteria or cannot safely have an operation may have scheduled blood, kidney and bone monitoring. Medicines or good hydration may help control calcium when surgery is delayed or unsuitable, but they do not remove the adenoma. A clinician determines the monitoring schedule and treatment plan based on calcium levels, symptoms and overall health.

A parathyroid adenoma is usually curable when the overactive gland is successfully removed. Symptoms and effects on the bones or kidneys may take time to improve, especially if high calcium has been present for a long time.

After treatment, healthcare professionals check calcium and parathyroid hormone levels to confirm that the condition has resolved. Persistent or recurrent disease is uncommon but possible, particularly when more than one gland is involved. People managed without surgery also need ongoing monitoring for changes in calcium, kidney function and bone health.

Arrange a medical evaluation for kidney stones, unexplained bone loss, persistent thirst or urination, fatigue, nausea, an abnormal calcium result or a suspected growth near the thyroid. These findings do not prove a parathyroid adenoma, but blood and urine testing can help identify parathyroid disease and high calcium.