Parathyroid lumps, also known as parathyroid tumours, are growths inside a parathyroid gland. In general, they are benign (not cancer), but in very rare cases, they can occur when cancer causes abnormal cells which grow to form a mass. Parathyroid lumps can be removed by an experienced ent surgeon.
There are four parathyroid glands, which are small glands in the neck, close to the thyroid gland. ‘’Para’’ means near and hence the name parathyroid gland. The parathyroid glands make up part of the endocrine system, which controls hormones in the body.
Parathyroid lumps can cause high levels of the parathyroid hormone, which can increase the calcium in your blood to potentially dangerous levels (hypercalcemia).
Causes of parathyroid lumps
In most cases, doctors are not sure what the cause of a parathyroid lump on one of the glands is. Genetics might play a part, while being subject to radiation exposure and being a woman over the age of 60 are other factors that are understood to increase your chances of developing a parathyroid lump.
Common symptoms caused by hyperparathyroidism (commonest cause is the benign parathyroid lump called an adenoma) include constipation, frequent urination, increased thirst, joint pain, kidney pain (due to the presence of kidney stones), lethargy and fatigue, loss of appetite, muscle weakness, abdominal pain (particularly unexplained abdominal pain), depression, memory loss, nausea and vomiting.
Parathyroid lump treatment
Parathyroid lumps can be diagnosed via a blood test that checks for increased levels of the parathyroid hormone. There are also other signs that you may have a parathyroid lump which are the result of elevated parathyroid hormone levels. These include abnormal levels of phosphate and calcium in the blood. In mild cases of parathyroid lumps, your parathyroid lump specialist might monitor the condition rather than perform surgery depending on your general health. There are also medications called calcimimetics to reduce the secretion of the parathyroid hormone - these are usually a temporary measure.
Parathyroid lumps can cause a condition called hyperparathyroidism, which can result in kidney stones and bone fractures. For this reason, other tests can involve looking for kidney stones with an imaging test (x-ray, ultrasound or CT scan) and checking your bone density.
There are a lot of misconceptions around when surgery is required for primary hyperparathyroidism e.g., although very high calcium levels is one reason to advise surgery, high calcium levels do not necessarily correlate with the severity of the disease. The severity of disease correlates more with how long the calcium levels have been high. Some patients with ‘’not very high levels of calcium’’ may have very severe symptoms.
When the surgical removal of a parathyroid lump is required, you would first have the location of the lump verified and have all four glands checked to see if there is more than one. This is usually done with two different types of scans and sometimes a third scan. Only around 10 per cent of people with a parathyroid lump have them in more than one gland. Another misconception is that negative scans mean an operation should not go ahead - there are a variety of reasons why an adenoma may not show up on a scan
The outlook for surgical removal is very good, being successful in treating parathyroid lumps in around 90 per cent of cases. Recovery time after a minimally invasive parathyroid lump removal (parathyroidectomy) is just a few days, with patients being able to return to work within one to two weeks or sometimes sooner if they work from home. The scar is minimal and neat.