Parathyroid adenoma overview

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Overview

A parathyroid adenoma is a benign tumor of the parathyroid gland. Parathyroid adenoma can be associated with overexpression of the cyclin D1 gene. An elevated concentration of serum calcium and serum parathyroid hormone is diagnostic of parathyroid gland. A specific test for parathyroid adenoma is sestamibi parathyroid scintigraphy, the sestamibi scan. Surgery is the mainstay of treatment for parathyroid cancer.

Pathophysiology

  • 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 back surface of the thyroid in the neck. The parathyroids secrete parathyroid hormone (PTH), which increases the concentration of calcium in the blood by inducing the bones to release calcium into the blood and the kidneys to reabsorb it from the urine. When a parathyroid adenoma causes hyperparathyroidism, more parathyroid hormone is secreted, causing the calcium concentration of the blood to rise, resulting in hypercalcemia.[2]

Genetics

  • Parathyroid adenoma can be associated with overexpression of the cyclin D1 gene.[3]

Gallery

  • Intermediate/Low magnification micrograph of parathyroid adenoma. H&E stain. Features: Single cell population forming a single mass. Thin capsule. No adipose tissue. +/-Glandular architecture (which may lead to confusion with thyroid tissue). Normal parathyroid gland with prominent adipose tissue is seen on the right of the image.[4]

    Intermediate/Low magnification micrograph of parathyroid adenoma. H&E stain. Features: Single cell population forming a single mass. Thin capsule. No adipose tissue. +/-Glandular architecture (which may lead to confusion with thyroid tissue). Normal parathyroid gland with prominent adipose tissue is seen on the right of the image.[4]

  1. ↑ Sekine O, Hozumi Y, Takemoto N, Kiyozaki H, Yamada S, Konishi F (March 2004). "Parathyroid adenoma without hyperparathyroidism". Japanese Journal of Clinical Oncology. 34 (3): 155–8. doi:10.1093/jjco/hyh028. PMID 15078912.
  2. ↑ Felsenfeld AJ, Rodríguez M, Aguilera-Tejero E (November 2007). "Dynamics of parathyroid hormone secretion in health and secondary hyperparathyroidism". Clinical Journal of the American Society of Nephrology. 2 (6): 1283–305. doi:10.2215/CJN.01520407. PMID 17942777.
  3. ↑ Hsi ED, Zukerberg LR, Yang WI, Arnold A (May 1996). "Cyclin D1/PRAD1 expression in parathyroid adenomas: an immunohistochemical study". The Journal of Clinical Endocrinology and Metabolism. 81 (5): 1736–9. doi:10.1210/jcem.81.5.8626826. PMID 8626826.
  4. ↑ Parathyroid adenoma. Wikipedia(2015). https://en.wikipedia.org/wiki/Parathyroid_adenoma Accessed on December 29, 2015
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