Parathyroidectomy (cont.)
What causes hyperparathyroidism?
There are two types of hyperparathyroidism, primary and
secondary. The most common disorder of the parathyroid glands and one that
causes primary hyperparathyroidism, is a small, tumor called a
parathyroid adenoma. A parathyroid
adenoma is a benign condition in which one parathyroid gland increases
in size and produces PTH in excess. (As opposed to parathyroid adenoma,
it should be noted that malignant tumors of the parathyroid glands, that
is, cancer, is very rare.) In most situations patients are unaware
of the adenoma, and they are found when routine blood test
results show an elevated blood calcium and PTH level. Less
commonly, primary hyperparathyroidism may be caused by overactivity of
all of the parathyroid glands, referred to as parathyroid hyperplasia.
With secondary hyperparathyroidism, the secretion of PTH is caused by a
nonparathyroid disease, usually kidney failure.
When is a parathyroidectomy necessary and how is it performed?
Parathyroidectomy is necessary
when calcium levels are elevated, if there is a complication of
hyperparathyroidism, or if a patient is relatively young. During a parathyroidectomy, the
surgeon delicately removes one or more of the tiny parathyroid glands. In some
situations, both sides of the neck are explored, while in other cases a direct
approach is made through a small incision (referred to as a minimally invasive
parathyroidectomy). Tests such as a high-resolution ultrasound or a nuclear
medicine scan (called a sestamibi scan) help to direct the approach preoperatively or intra-operatively by
identifying the location of the overactive, enlarged
gland. In rare situations, the offending gland cannot be found. (A portion of a
gland also may be transplanted to another site in the neck or the arm to preserve parathyroid
function.)
Whereas preoperative
tests help to identify hyperparathyroidism and to direct the surgical
approach, PTH levels obtained during parathyroidectiomy help to guarantee the successful
resection
of the abnormal gland by demonstrating a return of the PTH levels to normal after
the suspected parathyroid adenoma is removed. Using this method, a PTH
determination is obtained immediately prior to the resection and
compared to a PTH determination done ten minutes after the resection.
Next: What are the risks of parathyroidectomy? »
- CT Scan (Computerized Axial Tomography) - CT Scan (Computerized Axial Tomography, CAT scan) is a procedure that assists in diagnosing tumors, fractures, bony structures, and infections in the organs and tissues of the body.
- Hyperparathyroidism - Learn about hyperparathyroidism, a parathyroid disorder. Symptoms include depression, loss of appetite, nausea, vomiting, constipation, and more. Diagnosis and treatment options are discussed in the material.
- MRI (Magnetic Resonance Imaging Scan) - Medical information on magnetic resonance imaging (MRI) used in detecting structural abnormalities of the body. Learn uses, risks, and how to prepare for an MRI scan
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