|
|
| (76 intermediate revisions by 6 users not shown) |
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| {{SI}} | | {{Parathyroid adenoma}} |
| | {{CMG}}{{AE}}{{sali}} |
|
| |
|
| '''For patient information, click [[Insert page name here (patient information)|Insert page name here]]'''
| | ==[[Parathyroid adenoma overview|Overview]]== |
|
| |
|
| {{CMG}}
| | ==[[Parathyroid adenoma historical perspective|Historical Perspective]]== |
|
| |
|
| {{SK}}
| | ==[[Parathyroid adenoma classification|Classification]]== |
|
| |
|
| == Overview == | | ==[[Parathyroid adenoma pathophysiology|Pathophysiology]]== |
|
| |
|
| ==Historical Perspective== | | ==[[Parathyroid adenoma causes|Causes]]== |
|
| |
|
| ==Classification== | | ==[[Parathyroid adenoma differential diagnosis|Differentiating Vulvar cancer from other Diseases]]== |
|
| |
|
| == Pathophysiology== | | ==[[Parathyroid adenoma epidemiology and demographics|Epidemiology and Demographics]]== |
| * A parathyroid adenoma is a [[adenoma|benign tumor]] of the [[parathyroid gland]]. It generally causes [[hyperparathyroidism]]; there are very few reports of parathyroid adenomas that were not associated with hyperparathyroidism.<ref name=sekine>{{cite journal |author=Sekine O, Hozumi Y, Takemoto N, Kiyozaki H, Yamada S, Konishi F |title=Parathyroid adenoma without hyperparathyroidism |journal=Japanese Journal of Clinical Oncology |volume=34 |issue=3 |pages=155–8 |date=March 2004 |pmid=15078912 |doi=10.1093/jjco/hyh028}}</ref>
| |
| * A human being usually has four parathyroid glands located on the back surface of the [[thyroid]] in the neck. The parathyroids secrete [[parathyroid hormone]] (PTH), which increases the concentration of [[calcium]] in the blood by inducing the [[bone]]s to release calcium into the blood and the [[kidney]]s to reabsorb it from the urine into the blood. When a parathyroid adenoma causes hyperparathyroidism, more parathyroid hormone is secreted, causing the calcium concentration of the blood to rise, resulting in [[Hypercalcaemia|hypercalcemia]].<ref name=fel>{{cite journal |author=Felsenfeld AJ, Rodríguez M, Aguilera-Tejero E |title=Dynamics of parathyroid hormone secretion in health and secondary hyperparathyroidism |journal=Clinical Journal of the American Society of Nephrology |volume=2 |issue=6 |pages=1283–305 |date=November 2007 |pmid=17942777 |doi=10.2215/CJN.01520407}}</ref>
| |
|
| |
|
| === Genetics === | | ==[[Parathyroid adenoma risk factors|Risk Factors]]== |
| * Parathyroid adenoma can be associated with overexpression of the [[cyclin D1]] gene.<ref>{{cite journal |author=Hsi ED, Zukerberg LR, Yang WI, Arnold A |title=Cyclin D1/PRAD1 expression in parathyroid adenomas: an immunohistochemical study |journal=The Journal of Clinical Endocrinology and Metabolism |volume=81 |issue=5 |pages=1736–9 |date=May 1996 |pmid=8626826 |doi=10.1210/jcem.81.5.8626826}}</ref>
| |
|
| |
|
| ==Causes== | | ==[[Parathyroid adenoma screening|Screening]]== |
| ===Life Threatening Causes===
| |
| Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
| |
|
| |
|
| ===Common Causes=== | | ==[[Parathyroid adenoma natural history, complications and prognosis|Natural history, complications and prognosis]]== |
|
| |
|
| ===Causes by Organ System===
| | ==Diagnosis== |
| | | [[Parathyroid adenoma history and symptoms|History and Symptoms]] | [[Parathyroid adenoma physical examination|Physical Examination]] [[Parathyroid adenoma CT|CT]] | [[Parathyroid adenoma MRI|MRI]] | [[Parathyroid adenoma other imaging findings|Other Imaging Findings]] | [[Parathyroid adenoma other diagnostic studies|Other Diagnostic Studies]] |
| ===Causes in Alphabetical Order===
| |
| | |
| ==Differentiating type page name here from other Diseases==
| |
| | |
| == Epidemiology and Demographics ==
| |
| ===Age===
| |
| ===Gender===
| |
| ===Race===
| |
| ===Developed Countries===
| |
| ===Developing Countries===
| |
| | |
| == Risk Factors ==
| |
| | |
| == Screening ==
| |
| | |
| == Natural History, Complications and Prognosis==
| |
| | |
| == Diagnosis == | |
| ===Diagnostic Criteria===
| |
| Hyperparathyroidism is confirmed by blood tests such as calcium and PTH levels.
| |
| | |
| ===History===
| |
| A directed history should be obtained to ascertain
| |
| | |
| === Symptoms ===
| |
| "Type symptom here" is pathognomonic of the "type disease name here".
| |
| | |
| "Type non specific symptoms" may be present.
| |
| | |
| ===Past Medical History===
| |
| | |
| ===Family History===
| |
| | |
| ===Social History===
| |
| ====Occupational====
| |
| ====Alcohol====
| |
| The frequency and amount of alcohol consumption should be characterized.
| |
| ====Drug Use====
| |
| ====Smoking====
| |
| | |
| ===Allergies===
| |
| | |
| === Physical Examination ===
| |
| | |
| ==== Appearance of the Patient ====
| |
| | |
| ====Vital Signs====
| |
| | |
| ====Skin====
| |
| | |
| ====Head====
| |
| | |
| ==== Eyes ====
| |
| | |
| ==== Ear ====
| |
| | |
| ====Nose====
| |
| | |
| ====Mouth====
| |
| | |
| ====Throat ====
| |
| | |
| ==== Heart ====
| |
| | |
| ==== Lungs ====
| |
| | |
| ==== Abdomen ====
| |
| | |
| ==== Extremities ====
| |
| | |
| ==== Neurologic ====
| |
| | |
| ====Genitals====
| |
| | |
| ==== Other ====
| |
| | |
| === Laboratory Findings ===
| |
| ==== Other Imaging Findings ====
| |
| * A specific test for parathyroid adenoma is [[sestamibi parathyroid scintigraphy]], the sestamibi scan. This [[Nuclear medicine|nuclear imaging technique]] reveals the presence and location of pathological parathyroid tissue.<ref>{{cite journal |author=Goldstein RE, Billheimer D, Martin WH, Richards K |title=Sestamibi scanning and minimally invasive radioguided parathyroidectomy without intraoperative parathyroid hormone measurement |journal=Annals of Surgery |volume=237 |issue=5 |pages=722–30; discussion 730–1 |date=May 2003 |pmid=12724639 |pmc=1514518 |doi=10.1097/01.SLA.0000064362.58751.59}}</ref>
| |
| | |
| ===Imaging Findings===
| |
| '''Patient #1'''
| |
| <gallery>
| |
| Image:
| |
| | |
| Parathyroid-adenoma-001.jpg | |
| | |
| Image:
| |
| | |
| Parathyroid-adenoma-002.jpg
| |
| | |
| </gallery>
| |
| | |
| '''Patient #2'''
| |
| | |
| <gallery>
| |
| Image:
| |
| | |
| Parathyroid-adenoma-101.jpg
| |
| | |
| Image:
| |
| | |
| Parathyroid-adenoma-102.jpg
| |
| | |
| Image:
| |
| | |
| Parathyroid-adenoma-103.jpg
| |
| | |
| </gallery>
| |
| | |
| === Other Diagnostic Studies ===
| |
| | |
| == Treatment ==
| |
| === Pharmacotherapy ===
| |
| | |
| ==== Acute Pharmacotherapies ====
| |
| | |
| ==== Chronic Pharmacotherapies ====
| |
| | |
| === Surgery and Device Based Therapy ===
| |
| | |
| ==== Indications for Surgery ====
| |
| | |
| ==== Pre-Operative Assessment ====
| |
| | |
| ==== Post-Operative Management ====
| |
| | |
| ==== Transplantation ====
| |
| | |
| === Primary Prevention ===
| |
| | |
| === Secondary Prevention ===
| |
| | |
| === Cost-Effectiveness of Therapy ===
| |
| | |
| === Future or Investigational Therapies ===
| |
| | |
| ==References==
| |
| {{Reflist|2}}
| |
| | |
| [[Category:Disease]]
| |
| [[Category:Help]]
| |
| | |
| | |
| | |
| ==Related Chapters==
| |
| *[[Hyperparathyroidism]]
| |