Skip to main content
SpringerLink
Log in

Parathyroid tumors

  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Parathyroid tumors causing primary hyperparathyroidism are common and often remain undiagnosed, despite that the diagnostic work-up is uncomplicated in most patients. The patients often do not receive the appropriate curative treatment, which is surgical. Recent studies show that surgery is beneficial in patients with mild asymptomatic disease, especially in the reversal of bone disease, neuropsychologic symptoms, and dyslipoproteinemia. All patients with the disease deserve a referral to an endocrine surgeon for discussions regarding surgical intervention. Minimally invasive techniques performed in the ambulatory setting have evolved rapidly and show an extraordinary high success rate, low-morbidity rate, and are likely to become the standard treatment for most patients with primary hyperparathyroidism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Carling T: Molecular pathology of parathyroid tumors. Trends Endocrinol Metab 2001, 12:53–58.

    Article  PubMed  CAS  Google Scholar 

  2. Lundgren E, Rastad J, Åkerström G, Ljunghall S: Population-based health screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery 1997, 121:287–294.

    Article  PubMed  CAS  Google Scholar 

  3. Melton LJ 3rd: The epidemiology of primary hyperparathyroidism in North America. J Bone Miner Res 2002, 17(Suppl 2):N12-N17.

    PubMed  Google Scholar 

  4. Marx SJ, Simonds WF, Agarwal SK, et al.: Hyperparathyroidism in hereditary syndromes: special expressions and special managements. J Bone Miner Res 2002, 17(Suppl 2):N37-N43.

    PubMed  CAS  Google Scholar 

  5. Chattopadhyay N, Mithal A, Brown EM: The calciumsensing receptor: a window into the physiology and pathophysiology of mineral ion metabolism. Endocrine Rev 1996, 17:289–307.

    Article  CAS  Google Scholar 

  6. Carling T, Rastad J, Szabo E, et al.: Reduced vitamin D receptor mRNA levels in parathyroid glands of primary and secondary hyperparathyroidism. J Clin Endocrinol 2000, 85:2000–2003.

    Article  CAS  Google Scholar 

  7. Farnebo F, Enberg U, Grimelius L, et al.: Tumor-specific decreased expression of calcium sensing receptor messenger ribonucleic acid in sporadic primary hyperparathyroidism. J Clin Endocrinol Metab 1997, 82:3481–3486.

    Article  PubMed  CAS  Google Scholar 

  8. Carling T, Kindmark A, Hellman P, et al.: Vitamin D receptor genotypes in primary hyperparathyroidism. Nat Med 1995, 1:1309–1311.

    Article  PubMed  CAS  Google Scholar 

  9. Carpten JD, Robbins CM, Villablanca A, et al.: HRPT2, encoding parafibromin, is mutated in hyperparathyroidism-jaw tumor syndrome. Nat Genet 2002, 32:676–680.

    Article  PubMed  CAS  Google Scholar 

  10. Bilezikian J, Potts JJ, Fuleihan GH, et al.: Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol Metab 2002, 87:5353–5361. A summary of a recent workshop by the National Institutes of Health on asymptomatic primary hyperparathyroidism. The paper reflects a consensus by worldwide experts in endocrinology and surgery.

    Article  PubMed  CAS  Google Scholar 

  11. Nilsson I, Yin L, Lundgren E, et al.: Clinical presentation of primary hyperparathyroidism in Europe--nationwide cohort analysis on mortality from nonmalignant causes. J Bone Miner Res 2002, 17(Suppl 2):N68-N74. This article presents a comprehensive epidemiologic analysis of essentially all patients operated on for parathyroid adenoma during 40 years in Sweden and includes 102,515 observed person-years. An increased risk of excess mortality caused by cardiovascular disease, diabetes mellitus, and urogenital is substained. The study further indicates that a modern, more liberal approach, to operative intervention normalizes the risk of death in these patients.

    PubMed  Google Scholar 

  12. Silverberg S, Shane E, Jacobs T, et al.: A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med 1999, 341:1249–1255.

    Article  PubMed  CAS  Google Scholar 

  13. Utiger R: Treatment of primary hyperparathyroidism. N Engl J Med 1999, 341:1301–1302.

    Article  PubMed  CAS  Google Scholar 

  14. Marx SJ: Familial hypocalciuric hypercalcemia. In Primer on the Metabolic Bone Disease and Disorders of Mineral Metabolism. Edited by Favus MJ. Philadelphia: Lippincott-Raven; 1996:90–192.

    Google Scholar 

  15. Carling T, Szabo E, Bai M, et al.: Familial hypercalcemia and hypercalciuria caused by a novel mutation in the cytoplasmic tail of the calcium receptor. J Clin Endocrinol Metab 2000, 85:2042–2047.

    Article  PubMed  CAS  Google Scholar 

  16. Peacock M: Primary hyperparathyroidism and the kidney: biochemical and clinical spectrum. J Bone Miner Res 2002, 17(Suppl 2):N87-N94.

    PubMed  CAS  Google Scholar 

  17. Udelsman R: Parathyroid imaging: the myths and the reality. Radiology 1996, 201:317–318.

    PubMed  CAS  Google Scholar 

  18. Alexander HR Jr, Chen CC, Shawker T, et al.: Role of preoperative localization and intraoperative localization maneuvers including intraoperative PTH assay determination for patients with persistent or recurrent hyperparathyroidism. J Bone Miner Res 2002, 17(Suppl 2):N133-N140.

    PubMed  Google Scholar 

  19. Udelsman R, Aruny JE, Donovan PI, et al.: Rapid parathyroid hormone analysis during venous localization. Ann Surg 2003, in press.

  20. O’Herrin J, Weigel T, Wilson M, Chen H: Radioguided parathyroidectomy via VATS combined with intraoperative parathyroid hormone testing: the surgical approach of choice for patients with mediastinal parathyroid adenomas? J Bone Miner Res 2002, 17:1368–1371.

    Article  PubMed  Google Scholar 

  21. Udelsman R: Surgery in primary hyperparathyroidism: the patient without previous neck surgery. J Bone Miner Res 2002, 17(Suppl 2):N126-N132.

    PubMed  Google Scholar 

  22. Stojadinovic A, Shaha A, Orlikoff R, et al.: Prospective functional voice assessment in patients undergoing thyroid surgery. Ann Surg 2002, 236:823–832.

    Article  PubMed  Google Scholar 

  23. Udelsman R: Six hundred fifty-six consecutive explorations for primary hyperparathyroidism. Ann Surg 2002, 235:665–670.

    Article  PubMed  Google Scholar 

  24. Henry J, Iacobone M, Mirallie E, et al.: Indications and results of video-assisted parathyroidectomy by a lateral approach in patients with primary hyperparathyroidism. Surgery 2001, 130:999–1004.

    Article  PubMed  CAS  Google Scholar 

  25. Rao D, Agarwal G, Talpos G, et al.: Role of vitamin D and calcium nutrition in disease expression and parathyroid tumor growth in primary hyperparathyroidism: a global perspective. J Bone Miner Res 2002, 17(Suppl 2):N75-N80.

    PubMed  CAS  Google Scholar 

  26. van der Wielen R, Lowik M, van den Berg H, et al.: Serum vitamin D concentrations among elderly people in Europe. Lancet 1995, 346:207–210.

    Article  PubMed  Google Scholar 

  27. http://www.micromedex.com. Accessed February, 2003.

  28. Antoniucci D, Shoback D: Calcimimetics in the treatment of primary hyperparathyroidism. J Bone Miner Res 2002, 17(Suppl 2):N141-N145.

    PubMed  CAS  Google Scholar 

  29. Collins M, Skarulis M, Bilezikian J, et al.: Treatment of hypercalcemia secondary to parathyroid carcinoma with a novel calcimimetic agent. J Clin Endocrinol Metab 1998, 83:1083–1088.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Yale University School of Medicine, 330 Cedar Street, FMB 102, Box 208062, 06510, New Haven, CT, USA

    Robert Udelsman MD, MBA

Authors
  1. Tobias Carling MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert Udelsman MD, MBA
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carling, T., Udelsman, R. Parathyroid tumors. Curr. Treat. Options in Oncol. 4, 319–328 (2003). https://doi.org/10.1007/s11864-003-0007-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11864-003-0007-x

Keywords

Search

Navigation