Diagnosis and management of parathyroid adenoma

A parathyroid adenoma refers to a non-cancerous tumour that develops on one of the parathyroid glands. The parathyroid glands are located close to the thyroid gland and produce a chemical known as parathyroid hormone, which helps to regulate the levels of calcium and phosphorus in the blood. When an adenoma affects these glands, more parathyroid hormone is produced than normal, disrupting the balance of calcium and phosphorus in the blood, and hyperparathyroidism develop. If Dr Roodt suspects you may have an adenoma, she will perform blood tests as well as an ultrasound and special scan to help her make an accurate diagnosis and localize the lesion. Treatment of the condition typically involves the surgical removal of the parathyroid adenoma by means of a focused parathyroidectomy as well as further follow-up by an endocrinologist.

Management of parathyroid hyperplasia

Parathyroid hyperplasia is a condition in which all parathyroid glands are abnormally enlarged. This is most commonly found in patients with renal failure. In these cases, we work closely with renal and endocrine physicians to determine the best course of action and timing of surgical removal of the parathyroid glands. Commonly 3.5 of the 4 glands are removed by means of a four gland parathyroid exploration.

Are parathyroid adenomas painful?
You could have neck discomfort and a sore throat that makes swallowing difficult when you have parathyroid adenoma. Pai, however, is very rare.
What is a four-gland parathyroid exploration?
Dr Roodt will make a tiny incision in the lower neck and check all of the parathyroid glands to perform a four-gland exploration. There are very specific indications for a four gland exploration.
What is a targeted parathyroid exploration:
In the case of a parathyroid adenoma, the adenoma is ideally located pre-operatively using a special scan called a Setamibi scan. Other techniques include using an ultrasound and 4D CT scan of the neck. This enables Dr Roodt to do a less invasive procedure and target the adenoma that requires removal.
How long does it take to recover from parathyroid gland removal?
Dr Roodt may recommend a specific diet while you recover but suggest that you fully recover between one- and three weeks post-surgery.
How do I prepare for parathyroid surgery?
Dr Roodt has a document discussing all the information you need to know before you have parathyroid surgery, and this can be found by clicking: https://capebreastsurgeon.co.za/storage/2020/05/pre-operative-information-thyroid-and-parathyroid-surgery.pdf.