At Stanford Health Care, we’re leaders in caring for parathyroid tumors and disorders. Our skilled, caring doctors offer leading-edge techniques and advanced therapies to diagnose and treat parathyroid conditions.
What are parathyroid tumors?
A parathyroid tumor is a growth inside one or more of your parathyroid glands. The parathyroid glands are four small, oval-shaped glands in your neck that are close to your thyroid gland. These glands produce parathyroid hormone (PTH), which regulates calcium levels in your body. Your body needs precise calcium levels to keep your muscles, bones, and organs working properly.
Nearly all parathyroid tumors are benign (noncancerous). These types of tumors are called adenomas. Parathyroid cancer is extremely rare.
What is hyperparathyroidism?
Hyperparathyroidism occurs when one or more of your parathyroid glands becomes overactive and produces too much PTH. There are two different types of hyperparathyroidism and each has a different cause:
Primary hyperparathyroidism
Primary hyperparathyroidism results when one or more of your parathyroid glands overproduces PTH. High PTH leads to high calcium levels in your blood.
The most common cause of primary hyperparathyroidism is an adenoma on one gland. Most adenomas occur randomly, but in rare instances, there may be a genetic cause.
Other causes of primary hyperparathyroidism include:
- Enlargement of multiple parathyroid glands (hyperplasia)
- A cancerous tumor, which is extremely rare
Hyperparathyroidism is typically not dangerous, and in some cases does not require treatment. Over time, hyperparathyroidism can result in weak bones and a greater risk of osteoporosis and fractures. Kidney stones, decreased kidney function, and other health problems may also occur. Your doctor will discuss with you whether you need treatment.
Secondary hyperparathyroidism
Secondary hyperparathyroidism occurs when your parathyroid glands overproduce PTH to compensate for low calcium levels. The most common cause of secondary hyperparathyroidism is chronic kidney failure. Kidney failure causes low calcium levels in your blood, which can cause your parathyroid gland to enlarge and produce extra PTH.
Secondary hyperparathyroidism can also result from low vitamin D or calcium levels, either as a result of your diet or your body’s ability to absorb these nutrients.
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Understanding Parathyroid Tumors and Disorders
Symptoms of Hyperparathyroidism
Some people with hyperparathyroidism may not have any symptoms at all. When a parathyroid tumor causes hyperparathyroidism, symptoms may include:
- Aches and pains, including abdominal pain
- Constipation
- Confusion
- Depression
- Excessive urination
- Fatigue and muscle weakness
- Fragile bones or an unexplained broken bone
- Nausea and vomiting
- Unexplained weight loss
Hyperparathyroidism symptoms may resemble symptoms of other medical conditions or problems. Always consult your doctor for a diagnosis.
Most cases of primary hyperparathyroidism develop randomly without a specific cause. However, certain rare genetic disorders can lead to hyperparathyroidism, including:
- Familial isolated hyperparathyroidism (FIHP): Tumors in the parathyroid glands cause the glands to produce too much parathyroid hormone, which leads to hyperparathyroidism and hypercalcemia. No other endocrine glands are affected.
- Multiple endocrine neoplasia type 1 (MEN1) syndrome: People with MEN1 will often have tumors of the parathyroid glands, pancreas, and pituitary gland. The tumors are nearly always benign.
Our genetic counseling services can assess your genetic risk of hyperparathyroidism. We’ll develop a care plan for you and your family. Learn more about our Cancer Genetics Program.
In very rare cases, a parathyroid tumor can be cancerous. Cancerous parathyroid tumors produce very high levels of PTH, and often cause extreme increases in blood calcium levels.
Stages:
There is no standard process for determining the stage of parathyroid cancer. Doctors define the category based on whether the cancer has spread. The two categories are:
- Localized: The cancerous tumor is in the parathyroid gland and may have spread to nearby tissue but is still localized in the neck.
- Metastatic: Cancer cells have spread from the parathyroid gland to other areas such as the bones, heart, liver, lungs, lymph nodes, or pancreas.
At Stanford Health Care, we offer a full range of the latest diagnostic tests to help us plan the most effective treatment. Tests may include:
Blood tests
During a blood test, we draw a small sample of blood so it can be tested at a lab. Blood tests may include:
- Blood calcium test: Higher than normal amounts of calcium in your blood may indicate a parathyroid tumor.
- Parathyroid hormone test: Higher than normal levels of PTH may indicate a parathyroid tumor.
- Vitamin D: Many people have low vitamin D, and this can sometimes be a cause of secondary hyperparathyroidism.
- Creatinine and GFR (glomerular filtration rate): These are kidney tests to check whether your kidney function has been affected by hyperparathyroidism.
We measure the amount of calcium you lose in your urine over 24 hours. A high or high normal level indicates hyperparathyroidism, and may be associated with a risk of kidney stones.
We use a bone density test to measure any loss of bone.
Parathyroid imaging
Imaging tests provide detailed pictures of the inside of your body. Normal parathyroid glands are so small that they are not visible on most types of imaging. Abnormal parathyroid glands, which are larger and more active, can be detected on scans. Your doctor may order several imaging tests that use various technologies, including:
- Sestamibi (MIBI) scan: We identify overactive parathyroid glands by injecting a small amount of radioactive liquid into your body. Overactive parathyroid glands absorb the liquid and appear on the scan.
- Ultrasound: This imaging uses sound waves to produce pictures of your neck that show details of your neck anatomy.
- Computed tomography scan (CT scan): We take detailed images of your neck from multiple angles using a computer and X-ray technology to produce 3D images. You may receive an injection of contrast dye so that we can better see your parathyroid gland.
- Single photon-emission computed tomography (SPECT): To look for overactive cells in your neck, we inject radioactive liquid into a vein or ask you to inhale a radioactive gas through your nose. As the liquid flows through your bloodstream, a specialized camera takes 3D pictures of your neck. Bright areas on the pictures indicate increased blood flow, which suggests increased activity.
- Venous sampling: We collect blood from veins near your parathyroid glands to help determine which gland is making too much parathyroid hormone.
If you are diagnosed with parathyroid cancer, we perform imaging tests to determine whether cancer has spread to other areas such as your bones, heart, liver, lungs, lymph nodes, or pancreas. These imaging tests may include a CT scan, PET/CT scan, or MRI.
Parathyroid Tumors and Disorders (v3)
Our team of specialists can help with parathyroid tumor care. Learn more about our advanced diagnosis and treatment options for parathyroid tumors and disorders.
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Symptoms of parathyroid disorders
diagnosing parathyroid tumors
parathyroid surgery
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