Parathyroid

Parathyroid

What are the parathyroid glands?
The parathyroid glands are four pea-sized glands located on the thyroid gland in the neck. Occasionally, a person is born with one or more of the parathyroid glands embedded in the thyroid, in the thymus, or located elsewhere around this area. In most such cases, however, the glands function normally.

Though their names are similar, the thyroid and parathyroid glands are entirely different glands, each producing distinct hormones with specific functions. The parathyroid glands secrete PTH, a substance that helps maintain the correct balance of calcium and phosphorus in the body. PTH regulates the level of calcium in the blood, release of calcium from bone, absorption of calcium in the intestine, and excretion of calcium in the urine. When the level of calcium in the blood falls too low, the parathyroid glands secrete just enough PTH to restore the blood calcium level.

What is hyperparathyroidism?
If the parathyroid glands secrete too much hormone, as happens in primary hyperparathyroidism, the balance is disrupted: Blood calcium rises. This condition of excessive calcium in the blood, called hypercalcemia, is what usually signals the doctor that something may be wrong with the parathyroid glands. In 85 percent of people with primary hyperparathyroidism, a benign tumor called an adenoma has formed on one of the parathyroid glands, causing it to become overactive. Benign tumors are noncancerous. In most other cases, the excess hormone comes from two or more enlarged parathyroid glands, a condition called hyperplasia. Very rarely, hyperparathyroidism is caused by cancer of a parathyroid gland.
This excess PTH triggers the release of too much calcium into the bloodstream. The bones may lose calcium, and too much calcium may be absorbed from food. The levels of calcium may increase in the urine, causing kidney stones. PTH also lowers blood phosphorus levels by increasing excretion of phosphorus in the urine.

Parathyroid Surgery - Parathyroidectomy

The underlying principle behind limited exploration is the fact that approximately 90% of individuals with primary hyperparathyroidism have only one diseased gland. The challenge is then to find the culprit gland successfully prior to operation. The essential imaging techniques used to localize solitary parathyroid adenomas are parathyroid sestamibi (a nuclear medicine test) and ultrasound.