In the parathyroid gland, adenomas( benign neoplasms) and carcinomas( malignant) can appear.In most cases, they are hormonal-active and lead to the development of hyperparathyroidism - an ailment in which parathyroid hormone parathyroid hormones are produced in large quantities.The presence of a tumor can indicate a lump on the neck, which squeezes adjacent organs - the trachea, esophagus, but the final diagnosis is made after a comprehensive survey.Table of Contents: General Information Causes Symptoms of Parathyroid Gland Disease Diagnosis Treatment Prevention Prognosis for Parathyroid Gland Diseases
The parathyroid gland is located on the posterior surface of the thyroid gland.Normally, a man has two pairs of glands functioning - in the lower and upper parts of the organ, connected by an isthmus. The parathyroid gland is part of the endocrine system and provides the synthesis of parathyroid hormone, or parathyroid hormone, responsible for the calcium exchange of .
Parathyroid gland tumors are rare( in 2% of all cases of cancer). At the same time, 95% of all diagnoses confirm the presence of hormone-active tumors, while 5% are hormone-inactive.It is the effect on the synthesis of parathyroid hormones that allows doctors to suspect an ailment.
Please note! In the risk zone - people who have reached 50 - 60 years of age .
The mechanism of disease development scientists explain the degeneration of healthy cells of the gland.This happens under the influence of external factors, for example, if a person undergoes a course of radiation therapy aimed at irradiating the neck. When detecting a neoplasm, it is recommended to carry out treatment immediately, since in time the adenoma cells can grow into carcinoma.
Tumor grows slowly.Indicate its presence may be signs that do not cause discomfort in a person, so neoplasms are heavily diagnosed.
There are no exact reasons for the development of parathyroid gland tumors.In addition to irradiation, they indicate heredity, emphasizing that pathology affects people with multiple endocrine neoplasia syndrome.
Some researchers believe that favorable conditions for the development of tumors create beriberi caused by malnutrition, poisoning with salts of heavy metals.This leads to a low level of calcium in the body.
A possible cause of the development of pathology may also be a change in the structure of the protein molecule, calmodulin, which normally binds calcium ions and delivers them to the parathyroid cells.The pathology provokes chaotic mitosis of cells or their division, as a result of which their number increases, and the adenoma arises.
Symptoms of parathyroid lesions
Adenomas develop from the main secretory cells - parathyroid cells and are located in the lower glands.As for the symptoms, the effects of hyperparathyroidism, hypercalcemia, come to the forefront.
The patient develops a kidney syndrome that manifests itself:
- by thirst;
- by extinction of the concentration function of the kidneys;
- by the appearance of urolithiasis;
- development of renal tubular acidosis;
- diffuse nephrocalcinosis;
- renal failure.
Gastrointestinal syndrome entails:
- occurrence of gastric and duodenal ulcers;
- constipation and diarrhea;
- GER, or gastroesophageal reflux, in which the contents of the stomach are ejected again into the esophagus.
From the side of the cardiovascular system, there are:
- calcification of valves and blood vessels of the heart - deposition of calcium salts on the walls;
Please note! As a result of hypercalcemia, calcium salts can also be deposited in the surface layers of the cornea of the eyes, provoking the development of cataracts, keratitis.
If the central nervous system is affected, the person:
- quickly becomes tired;
- is experiencing constant weakness;
- suffers from headaches, psychosis, depression.
In the case of carcinoma, the configuration of the neck changes, as a result of which tuberosity, a cone with limited mobility , is probed.As the disease progresses, metastases grow into lymph nodes, lungs, less often bones, liver, kidneys.
When the tumor presses on the surrounding organs, is added to the above-described signs:
- dry cough;
- voice hoarseness;
- increased sweating;
- tenderness in bone structures.
Due to the development of urolithiasis, renal colic is observed, sometimes abdominal pain develops, bone fragility increases as a result of the appearance of osteoporosis .
Important! First of all, patients with a parathyroid tumor exhibit signs of hyperparathyroidism.In view of the fact that several organs are affected, which leads to blurred symptoms, diagnosis is difficult.
The presence of parathyroid gland tumors is confirmed by an endocrinologist, an oncologist.When choosing a therapy, the surgeon is advised.Initially, the patient is prescribed directions for laboratory tests of blood and urine( according to Nechiporenko), whose goal is to detect the level of parathyroid hormone, as well as the level of calcium and phosphorus.
To determine the location of the tumor, ultrasound, computerized tomography of the neck, substrate parathyroid scintigraphy ( radionuclide study consisting in the introduction of radioisotopes into the patient's body, which are absorbed by parathyroid gland tissues and allow their imaging using special equipment) are performed.
Please note! For the purpose of tumor visualization, selective angiography is performed.The procedure also allows for venous blood sampling to detect the level of parathyroid hormone in it.The shape of the tumor is determined by a fine needle aspiration biopsy.
If the doctor suspects the defeat of other organs, he will designate:
- ultrasound of the kidneys and abdominal cavity;
- X-ray of the esophagus and thorax;
- fibrogastroduodenoscopy - a method that allows you to assess the state of the stomach, esophagus and duodenum.
If necessary, consultations are given by a cardiologist, nephrologist, ophthalmologist, otolaryngologist, neurologist, gastroenterologist.
A comprehensive study allows excluding the presence of hyperplasia and confirming the presence of a tumor.
It is impossible to cure a parathyroid tumor by drug.The only way to eliminate it is surgical intervention of .The success of the operation directly depends on the preparation for it, therefore, before it is performed, patients are recommended dietary intake with a predominance of products with high calcium content and low phosphorus content.In other words, they are recommended to include fatty fish, beef, cereals, cottage cheese in the diet.
In addition, during the preparation phase intravenously inject saline, diuretics for boosting diuresis.If there is a risk of hypercalcemic crisis, glucose is also attributed to the solution and sodium bicarbonate.
The operation is performed under general anesthesia.In time, it stretches for 1 to 3 hours, depending on the location and the size of the tumor.In this case, the doctor can:
- completely remove the gland if thyroidectomy is performed;
- remove one share of thyroid gland when there is hemithyroidectomy;
- remove the isthmus of the gland;
- remove individual patches if subtotal ectomy is performed.
Important! The method of resection is selected individually based on the results of the examination of the patient.
You can prevent the development of the disease by monitoring your diet.In view of the fact that the disease develops as a result of calcium deficiency, care must be taken to ensure that it is sufficient, that is, to introduce into the diet dairy products, mushrooms, fatty fish and seafood, raw fruits and vegetables.
Some experts advise to additionally drink vitamins with a high content of calciferol.
Prognosis for parathyroid tumors
In most cases, after the operation, the prognosis is favorable.Doctors recommend that patients remain under their supervision during the rehabilitation period and regularly check the level of calcium in the body .It should be normalized on the second day after surgery.Normalization of other organs and systems is observed several months after the operation.Despite this, relapses are diagnosed in 50% of patients.
Parathyroid tumors are benign and malignant neoplasms that are the result of cell mutations.In view of the fact that they develop with a deficiency of calcium in the body, doctors recommend increasing the consumption of foods with this substance in the composition at the age of 50 years.
Chumachenko Olga, medical reviewer