Parathyroid cancer
Parathyroid carcinomaParathyroid cancer is a cancerous (malignant) growth in a parathyroid gland.
Malignant
The term "malignancy" refers to the presence of cancerous cells that have the ability to spread to other sites in the body (metastasize) or to invade...
Causes
The parathyroid glands control the calcium level in the body. There are 4 parathyroid glands, 2 on top of each lobe of the thyroid gland, which is located at the base of the neck.
Calcium
Calcium is the most plentiful mineral found in the human body. The teeth and bones contain the most calcium. Nerve cells, body tissues, blood, and ...
Parathyroid cancer is a very rare type of cancer. It affects men and women equally. The cancer often occurs in people older than 30.
The cause of parathyroid cancer is unknown. People with a genetic conditions called multiple endocrine neoplasia type I and hyperparathyroidism-jaw tumor syndrome have an increased risk for this disease. People who had head or neck radiation also may be at increased risk. But this type of radiation is more likely to cause thyroid cancer.
Multiple endocrine neoplasia type I
Multiple endocrine neoplasia (MEN) type I is a disease in which one or more of the endocrine glands are overactive or forms a tumor. It is passed do...
Symptoms
Symptoms of parathyroid cancer are mainly caused by a high level of calcium in the blood (hypercalcemia), and may affect different parts of the body.
Hypercalcemia
Hypercalcemia means you have too much calcium in your blood.
Symptoms include:
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Bone pain
Bone pain
Bone pain or tenderness is aching or other discomfort in one or more bones.
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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- Frequent thirst
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Frequent urination
Frequent urination
Frequent urination means needing to urinate more often than usual. Urgent urination is a sudden, strong need to urinate. This causes a discomfort i...
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Kidney stones
Kidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
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Nausea and vomiting
Nausea
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...
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Exams and Tests
Parathyroid cancer may be very hard to diagnose.
Your health care provider will perform a physical exam and ask about your medical history.
About half of the time, a provider finds parathyroid cancer by feeling the neck with their hands (palpation).
Palpation
Palpation is a method of feeling with the fingers or hands during a physical examination. The health care provider touches and feels your body to ex...
A cancerous parathyroid tumor tends to produce a very high amount of parathyroid hormone (PTH). Tests for confirming a diagnosis of parathyroid cancer may include:
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Blood calcium
Blood calcium
The calcium blood test measures the level of calcium in the blood. This article discusses the test to measure the total amount of calcium in your blo...
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Blood PTH
Blood PTH
The PTH test measures the level of parathyroid hormone in the blood. PTH stands for parathyroid hormone. It is a protein hormone released by the par...
Before surgery, you will have a special radioactive scan of the parathyroid glands. The scan is called the sestamibi scan. You may also have a neck ultrasound. These tests are done to confirm which parathyroid gland is abnormal.
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
Treatment
The following treatments may be used to correct hypercalcemia due to parathyroid cancer:
- Fluids through a vein (IV fluids)
- A natural hormone called calcitonin that helps control the blood calcium level
- Medicines that stop the breakdown and reabsorption of bones in the body
Surgery is the recommended treatment for parathyroid cancer. Sometimes, it is hard to find out if a parathyroid tumor is cancerous. Your provider may recommend surgery even without a confirmed diagnosis. Minimally invasive surgery, using smaller cuts, is becoming more common for parathyroid disease.
If tests before the surgery can find the affected gland, surgery may be done on just one side of your neck. If it isn't possible to find the problem gland before surgery, the surgeon will look at both sides of your neck.
Chemotherapy and radiation don't work well to prevent the cancer from coming back. Radiation may help reduce the spread of cancer to the bones.
Repeated surgeries for cancer that has returned may help:
- Improve the survival rate
- Reduce the severe effects of hypercalcemia
Outlook (Prognosis)
Parathyroid cancer is slow growing. Surgery may help extend life even when the cancer spreads.
Possible Complications
The cancer may spread (metastasize) to other places in the body, most often the lungs and bones.
Hypercalcemia is the most serious complication. Most deaths from parathyroid cancer occur due to severe, difficult-to-control hypercalcemia, and not the cancer itself.
The cancer often comes back (recurs). Further surgeries may be needed. Complications from surgery can include:
- Hoarseness or voice changes as a result of damage to the nerve that controls the vocal cords
- Infection at the site of surgery
- Low level of calcium in the blood (hypocalcemia), a potentially life-threatening condition (presenting as twitching movements or even seizures)
- Scarring
When to Contact a Medical Professional
Contact your provider if you feel a lump in your neck or experience symptoms of hypercalcemia.
References
Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Cancer of the endocrine system. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 68.
Fletcher CDM. Tumors of the thyroid and parathyroid glands. In: Fletcher CDM, ed. Diagnostic Histopathology of Tumors. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 18.
National Cancer Institute website. Parathyroid cancer treatment (PDQ) - health professional version. www.cancer.gov/types/parathyroid/hp/parathyroid-treatment-pdq. Updated July 22, 2020. Accessed May 7, 2024.
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Parathyroid glands - illustration
The 4 parathyroid glands are located near or attached to the back side of the thyroid gland and produce parathyroid hormone. Parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the blood and bone by maintaining a balance between the mineral levels in the blood and the bone.
Parathyroid glands
illustration
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Parathyroid biopsy - illustration
A parathyroid biopsy most often is performed as part of a surgical procedure to examine and/or remove the parathyroid glands because of disease. The parathyroid glands may be removed because of conditions such as a tumor or increased blood calcium levels. The parathyroid glands are located near the thyroid gland. They secrete parathyroid hormone (PTH), which functions primarily in the control of calcium levels.
Parathyroid biopsy
illustration
-
Parathyroid glands - illustration
The 4 parathyroid glands are located near or attached to the back side of the thyroid gland and produce parathyroid hormone. Parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the blood and bone by maintaining a balance between the mineral levels in the blood and the bone.
Parathyroid glands
illustration
-
Parathyroid biopsy - illustration
A parathyroid biopsy most often is performed as part of a surgical procedure to examine and/or remove the parathyroid glands because of disease. The parathyroid glands may be removed because of conditions such as a tumor or increased blood calcium levels. The parathyroid glands are located near the thyroid gland. They secrete parathyroid hormone (PTH), which functions primarily in the control of calcium levels.
Parathyroid biopsy
illustration
Review Date: 2/28/2024
Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.