Parathyroid adenoma versus primary hyperparathyroidism
This is a narrative review of literature. We focus on the issue of identifying a parathyroid adenoma without anomalies of function (non-functioning parathyroid adenoma) which is incidentally detected or not, via routine neck ultrasound or through advanced imaging techniques which are mostly performe...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Amaltea Medical Publishing House
2021-12-01
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| Series: | Romanian Medical Journal |
| Subjects: | |
| Online Access: | https://rmj.com.ro/articles/2021.4/RMJ_2021_4_Art-12.pdf |
| _version_ | 1797334611964985344 |
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| author | Mihai Cristian Dumitrascu Eugenia Petrova Diana Elena Rentea Stefania Zugravu Adina Ghemigian Mara Carsote Anda Dumitrascu Claudia Mehedintu Florica Sandru |
| author_facet | Mihai Cristian Dumitrascu Eugenia Petrova Diana Elena Rentea Stefania Zugravu Adina Ghemigian Mara Carsote Anda Dumitrascu Claudia Mehedintu Florica Sandru |
| author_sort | Mihai Cristian Dumitrascu |
| collection | DOAJ |
| description | This is a narrative review of literature. We focus on the issue of identifying a parathyroid adenoma without anomalies of function (non-functioning parathyroid adenoma) which is incidentally detected or not, via routine neck ultrasound or through advanced imaging techniques which are mostly performed for other conditions (like assessment of a non-parathyroid oncological condition or emergencies – related neck exploration).
The traditional diagnostic of primary hyperparathyroidism is exclusively a biological one based on high calcium and parathormone (PTH), and only a second step of assessment actually involves the localization procedures. However, the detection of a parathyroid tumor does not necessarily mean that it is associated with an over-secretion of PTH. Ultrasound is usually followed by Tc Sestamibi scintigram and/or computed tomography is order to refer the patient to parathyroidectomy in cases with biological confirmation of primary or renal hyperparathyroidism; yet, in cases with non-functioning profile, there is no clear indication of further imaging exploration.
In conclusion, the identification of a parathyroid adenoma is rarely associated with a normal parathyroid function and this entity, which most probably is an incidentaloma, is not a subject of particular guidelines yet. Whether it is necessary to continue with other imaging techniques as typically seen in primary hyperparathyroidism is still an open issue, and so is the panel of indications to perform its surgical removal instead of serial follow-up. |
| first_indexed | 2024-03-08T08:23:35Z |
| format | Article |
| id | doaj.art-7fd667d2d53e4111985440276443c1dc |
| institution | Directory Open Access Journal |
| issn | 1220-5478 2069-606X |
| language | English |
| last_indexed | 2024-03-08T08:23:35Z |
| publishDate | 2021-12-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Medical Journal |
| spelling | doaj.art-7fd667d2d53e4111985440276443c1dc2024-02-02T05:17:27ZengAmaltea Medical Publishing HouseRomanian Medical Journal1220-54782069-606X2021-12-0168447748110.37897/RMJ.2021.4.12Parathyroid adenoma versus primary hyperparathyroidismMihai Cristian Dumitrascu0Eugenia Petrova1Diana Elena Rentea2Stefania Zugravu3Adina Ghemigian4 Mara Carsote5Anda Dumitrascu6Claudia Mehedintu7Florica Sandru8University Emergency Hospital, Bucharest, Romania; “Carol Davila” University of Medicine and Pharmacy,“Carol Davila” University of Medicine and Pharmacy; “C. I. Parhon” National Institute of Endocrinology, Bucharest, Romania“C. I. Parhon” National Institute of Endocrinology, Bucharest, Romania“C. I. Parhon” National Institute of Endocrinology, Bucharest, Romania “Carol Davila” University of Medicine and Pharmacy; “C. I. Parhon” National Institute of Endocrinology, Bucharest, Romania “Carol Davila” University of Medicine and Pharmacy; “C. I. Parhon” National Institute of Endocrinology, Bucharest, Romania“C. I. Parhon” National Institute of Endocrinology, Bucharest, Romania “Carol Davila” University of Medicine and Pharmacy; ”Nicolae Malaxa” Clinical Hospital, Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy; Elias Emergency Hospital, Bucharest, RomaniaThis is a narrative review of literature. We focus on the issue of identifying a parathyroid adenoma without anomalies of function (non-functioning parathyroid adenoma) which is incidentally detected or not, via routine neck ultrasound or through advanced imaging techniques which are mostly performed for other conditions (like assessment of a non-parathyroid oncological condition or emergencies – related neck exploration). The traditional diagnostic of primary hyperparathyroidism is exclusively a biological one based on high calcium and parathormone (PTH), and only a second step of assessment actually involves the localization procedures. However, the detection of a parathyroid tumor does not necessarily mean that it is associated with an over-secretion of PTH. Ultrasound is usually followed by Tc Sestamibi scintigram and/or computed tomography is order to refer the patient to parathyroidectomy in cases with biological confirmation of primary or renal hyperparathyroidism; yet, in cases with non-functioning profile, there is no clear indication of further imaging exploration. In conclusion, the identification of a parathyroid adenoma is rarely associated with a normal parathyroid function and this entity, which most probably is an incidentaloma, is not a subject of particular guidelines yet. Whether it is necessary to continue with other imaging techniques as typically seen in primary hyperparathyroidism is still an open issue, and so is the panel of indications to perform its surgical removal instead of serial follow-up. https://rmj.com.ro/articles/2021.4/RMJ_2021_4_Art-12.pdfparathyroidhyperparathyroidismfunctioning parathyroid adenomanon-functioning parathyroid adenomaadenomatumorneoplasiaprimary hyperparathyroidismultrasound |
| spellingShingle | Mihai Cristian Dumitrascu Eugenia Petrova Diana Elena Rentea Stefania Zugravu Adina Ghemigian Mara Carsote Anda Dumitrascu Claudia Mehedintu Florica Sandru Parathyroid adenoma versus primary hyperparathyroidism Romanian Medical Journal parathyroid hyperparathyroidism functioning parathyroid adenoma non-functioning parathyroid adenoma adenoma tumor neoplasia primary hyperparathyroidism ultrasound |
| title | Parathyroid adenoma versus primary hyperparathyroidism |
| title_full | Parathyroid adenoma versus primary hyperparathyroidism |
| title_fullStr | Parathyroid adenoma versus primary hyperparathyroidism |
| title_full_unstemmed | Parathyroid adenoma versus primary hyperparathyroidism |
| title_short | Parathyroid adenoma versus primary hyperparathyroidism |
| title_sort | parathyroid adenoma versus primary hyperparathyroidism |
| topic | parathyroid hyperparathyroidism functioning parathyroid adenoma non-functioning parathyroid adenoma adenoma tumor neoplasia primary hyperparathyroidism ultrasound |
| url | https://rmj.com.ro/articles/2021.4/RMJ_2021_4_Art-12.pdf |
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