Generalities of Hyperparathyroidism

  • Single gland adenoma is the most common cause:
    • (75% to 90% of the cases of PHPT
  • Lower pole adenomas (in relation to the thyroid):
    • Are more common than are upper pole adenomas
  • The average size of a parathyroid gland is:
    • 6 mm X 4 mm X 2 mm
  • The sizes of a parathyroid adenoma range from:
    • 1 cm to 3 cm
  • The normal weight of a parathyroid gland is:
    • Approximately 40 mg to 50 mg
  • The weight of parathyroid adenomas vary between:
    • 553.7 +/- 520.5 mg (range, 66-2536)
  • Ectopic glands can be present in:
    • 4% to 16% of cases
  • PHPT is caused by:
    • The enlargement of a single parathyroid gland or parathyroid adenoma in approximately 75% to 90% of the cases
    • Multi-disease is seen in 15% to 25% of the cases:
      • Double adenomas:
        • Are seen in approximately 2% to 12% of the cases
      • Triple adenomas:
        • In less than 1% the cases (0.2%)
      • Four adenomas or parathyroid gland hyperplasia:
        • In less than 3% to 15% of the cases
    • Parathyroid carcinoma as the cause of PHPT is extremely rare in most parts of the world (~1%)
  • Most parathyroid adenomas consist of parathyroid chief cells:
    • They are usually encapsulated
    • In 50% of the cases they are surrounded by normal parathyroid tissue
  • Some adenomas, nevertheless, are composed of oxyphil cells
    • These adenomas are usually larger than chief cell adenomas
  • Parathyroid adenomas are sometimes located within the thymus:
    • They express a parathyroid-specific gene:
      • GCMB:
        • Contrasting with the normal thymus:
          • Which does not express neither PTH nor GCMB
  • In a study by Ruda et al:
    • 20, 225 patients with PHPT:
    • Parathyroid hyperplasia accounted for approximately six percent of cases
    • In parathyroid hyperplasia all four glands are enlarged:
      • With the lower glands typically being larger than the upper ones
      • The glands are usually composed of chief cells
      • Clear cell hyperplasia is very rare:
        • And is the only form in which the upper glands are larger than the lower ones

#Arrangoiz #ParathyroidSurgeon #ParathyroidExpert #HeadandNeckSurgeon #CancerSurgeon #EndocrineSurgery #Hyperparathyroidism #CASO #CenterforAdvancedSurgicalOncology

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