What is a Parathyroid Adenoma? Symptoms and Treatment

Weakness, fatigue, persistent back and waist pain... Endocrine Surgery Specialist Prof. Dr. Erhan AYŞAN, who points out that these complaints, which seriously impair our quality of life, may actually be a sign of a disease that silently damages the heart and kidneys, says, "Parathyroid adenoma is an insidious disease that may go unnoticed for years, but can be diagnosed with a simple blood test. Unfortunately, when diagnosis is delayed, we may face permanent health problems." Prof. Dr. AYŞAN emphasized that calcium levels must be checked in patients experiencing fatigue, exhaustion, and widespread body pain that cannot be diagnosed. 

What is Parathyroid Adenoma?

Yeditepe University Hospitals General Surgery and Endocrine Surgery Specialist Prof. Dr. Erhan AYŞAN, who states that parathyroid adenoma, which is unknown to the public, is a benign tumor originating from the parathyroid gland, says, "When we say ‘tumor,’ our patients immediately think of cancer. However, this is not cancer, but it is a disease that progresses insidiously and can therefore cause permanent damage to many organs in the body. When suspected, diagnosis is possible with a simple blood test. These patients have high calcium levels in their blood. High calcium in the blood causes serious damage to many systems in the body, primarily the heart and blood vessels. In patients who experience fatigue, exhaustion, and widespread body pain but cannot be diagnosed, blood calcium levels must be checked,“ he said. Prof. Dr. Erhan AYŞAN emphasized that parathyroid adenoma, which he defined as a ”hidden disease," is a serious disease that progresses insidiously, and provided detailed information about the disease.

What is the Parathyroid Gland? What does the Parathyroid Gland Do?

Prof.Dr. AYŞAN said, "The parathyroid glands are the smallest organs in the body, and their main function is to maintain calcium balance. They do this by secreting a hormone called parathyroid hormone. Parathyroid adenoma is a benign tumor originating from these glands that causes harm by secreting excessive amounts of parathyroid hormone into the blood. It is important that it is benign because the word ‘tumor’ immediately raises concerns about cancer in patients. As a result of excessive parathyroid hormone secretion, calcium levels in the blood rise. 

High calcium accumulates in the arteries and organs, causing various damage. This disease is also known as the ‘hidden disease’. There are three reasons for this: the parathyroid glands are very small, the symptoms progress insidiously, and it is difficult to find these small glands during surgery," he said.

What are the Symptoms of Parathyroid Adenoma?

Prof. Dr. AYŞAN stated that high calcium in the blood causes the most damage to the heart and vascular system, adding: "Excess calcium in the blood adheres to the walls of the blood vessels, forming layers that first narrow and then block the vessels, reducing or preventing blood flow. If this occurs in the heart vessels, it can lead to a heart attack; if it occurs in the brain vessels, it can lead to a stroke; if it occurs in the kidney vessels, it can lead to permanent kidney failure and lifelong dialysis. Parathyroid adenoma often causes very general complaints such as fatigue, tiredness, and back and waist pain, so it can often be confused with other diseases. When the diagnosis is not made, patients waste time with unnecessary tests. However, a calcium level above 10 in the blood should suggest parathyroid adenoma.

How is Parathyroid Adenoma Treated?

Hastalığın seyrinin sinsi olması nedeniyle teşhis koymanın güç olduğunu ve dolayısıyla tedavinin de geciktiğini söyleyen Prof. Ayşan, “İnsanlar bize genellikle kötü huylu bir hastalıkları olduğu endişesiyle geliyorlar. Ancak bu kesinlikle kötü huylu bir hastalık yani kanser değildir. Burada bizim ilk işimiz hastalarımızı bu konuda rahatlatmak oluyor” diye konuştu. Bu hastalığın tedavisinde ameliyatın mutlaka gerekli olduğunu ise şu cümlelerle anlattı: “Çünkü kandaki kalsiyum yüksekliği çok önemli bir sorun. Dünya Sağlık Örgütü son yıllarda kalsiyumun kandaki üst sınırını 10,5'dan 10'a indirdi. Bu çok önemli. Çünkü biz tıpta normal değerlerin revize edilmesi durumuyla çok az karşılaşırız. Bu durum, gelişen teknolojiyle kandaki yüksek kalsiyumun vücuda ne tür zararlar verdiğinin son yıllarda daha iyi anlaşılmasıyla gerçekleşti. Sadece bu olay bile kandaki yüksek kalsiyumun ve buna neden olan paratiroid adenomunun ne kadar önemli bir hastalık olduğunu gösteriyor ve adenomun ameliyatla biran önce vücuttan uzaklaştırılmasının önemini ortaya koyuyor.” diye konuştu.

How is Parathyroid Adenoma Diagnosed?

Emphasizing that a calcium level above 10 is critical for diagnosis, Prof. Dr. AYŞAN states, "If a parathyroid adenoma is diagnosed, surgery is absolutely necessary. The adenoma, which is a benign tumor, must be removed from the body through surgery. Treatment with medication is not possible. Before surgery, ultrasound and scintigraphy are used to try to locate the adenoma. However, this is not always successful. Unfortunately, we cannot always determine the location of the adenoma in preoperative examinations! In such patients, the surgery may take longer and be more difficult. Indeed, there is a famous saying in Endocrine Surgery: Parathyroid surgery either takes 30 minutes or 3 hours!"

Parathyroid Adenoma Surgery Aftercare

Başarılı bir ameliyattan sonra hastalarda hızlı bir iyileşme görüldüğünü söyleyen Prof. Ayşan, yüksek kalsiyum kandan hemen çekildiği için hastaların ameliyattan sonra yataktan ilk kalkışlarında bile kendilerini daha iyi hissettiklerini söyledi. Prof. Ayşan, “Yıllardır devam eden halsizlik, yorgunluk, depresif bulgular da hızla düzeliyor ve hasta kendini çok daha dinç ve enerjik hissediyor. Özellikle genç ve orta yaş grubunda iyileşme süreci çok daha hızlı oluyor. İleri yaşta ise kemik döngüsü yavaş olduğu için iyileşme biraz daha uzun sürebiliyor” dedi.

Parathyroid Adenoma Surgery Recovery Process

Prof. Dr. Erhan AYŞAN pointed out that after a successful surgery, risks associated with the disease, such as heart attack, stroke, and kidney failure, are also eliminated. He concluded his remarks with the following warnings: "Because it is a rare disease, it is difficult for our colleagues to consider this disease and include it in the differential diagnosis. Therefore, it is very important for people who experience fatigue, exhaustion, and widespread body pain but cannot be diagnosed to have a calcium test done on an empty stomach in the morning. This simple test, which can even be done at Family Health Centers, can be life-saving. If the calcium level is above 10, an endocrinologist should be consulted immediately."