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A parathyroid adenoma is a benign tumor of the parathyroid gland. It generally causes hyperparathyroidism; there are very few reports of parathyroid adenomas that were not associated with hyperparathyroidism. [1] A human being usually has four parathyroid glands located on the posterior surface of the thyroid in the neck.
During parathyroid surgery if there is an adenoma the transplantation is not recommended; instead it is cryopreserved for research an if there is a recurrent hypoparathyroidism. [ 2 ] [ 5 ] The surgery is indicated for all patients that are diagnosed with hyperparathyroidism with or without symptoms, especially in younger patients.
Chief cells in parathyroid adenomas also display acid phosphatase activity. [5] It is a benign tumor of the gland that requires surgical removal. [13] These benign adenomas are typically affect only one or two of the parathyroid glands, known respectively as a single adenoma or double adenoma. Typically, no disease is linked to the cause. [14]
Causes of primary hyperparathyroidism include parathyroid adenoma (80% of patients), multiglandular disease usually seen as hyperplasia of the 4 parathyroid glands (15-20% of patients), parathyroid carcinoma (less than 1% of patients). [15] Primary hyperparathyroidism occurs sporadically and most patients do not have a family history. [15]
Parathyroid carcinoma is a rare cancer resulting in parathyroid adenoma to carcinoma progression. [1] It forms in tissues of one or more of the parathyroid glands (four pea-sized glands in the neck that make parathyroid hormone (PTH). PTH helps the body maintain normal levels of serum calcium by promoting calcium reabsorption from bone.
The strap muscles are released off of the thyroid gland. Then the thyroid gland is mobilized and the parathyroid arterial blood supply is suture ligated. The entire parathyroid adenoma is identified and dissected out. Intraoperative PTH monitoring can begin at this time and will show falling PTH levels if the entire adenoma has been resected. [5]
A sestamibi parathyroid scan is a procedure in nuclear medicine which is performed to localize parathyroid adenoma, which causes Hyperparathyroidism. [1] Adequate localization of parathyroid adenoma allows the surgeon to use a minimally invasive surgical approach.
Intrathyroidal parathyroid tissue (d). The microscopic aspect of an intrathyroidal parathyroid adenoma is similar to eutopic parathyroid adenomas (e). Intrathyroidal parathyroid adenoma expressing chromogranin A (f) and PTH (g). Calcitonin-negative medullary thyroid carcinoma (h) showing positivity for CGRP (i).