Parathyroid adenoma

Parathyroid adenoma 

Updated: 07/02/2023

© Jun Wang, MD, PhD

General features
  • Most common cause of primary hyperparathyroidism
  • More common in women, usually in 30’s
  • Usually solitary lesion, monoclonal, functionally active
  • Difficult to diagnose - best criterion is lack of hypercalcemia for 5 years after excision
Clinical presentations
  • Associated with hypercalcemia and excessive calcium resorption
Key radiologic features
  • Sestamibi scan
Useful in detecting adenomas in patients with primary hyperparathyroidism
High specificity, low sensitivity
Not positive for hyperplasia
Not for secondary hyperparathyroidism
Pathological features
Genetic abnormalities
  • MEN1 gene mutation
  • Cyclin D1 overexpression
  • Other probably involved genes: RET, vitamin D receptor and the calcium-sensing receptor (CaSR)
  • Chromosomal abnormalities: Losses of 11q (most common), 1p, 6q, 9p, 11p, 13q and 15q and gains in 7, 16p and 19p, etc
Treatment
  • Surgery



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