endocrine and metabolic disorders
Parathyroid Tumors
Parathyroid adenoma
 (PTH), leading to Hyperparathyroidism which causes Parathyroid adenomas are most often isolated solitary adenomas and are more common among older women. However, parathyroid adenoma may occur as hereditary syndromes in patients with Overview of Multiple Endocrine Neoplasias (MEN) . Most parathyroid adenomas do not cause symptoms and are identified when blood tests done for another reason reveal elevated calcium levels. Symptoms of hyperparathyroidism may occur and are usually due to hypercalcemia or Urinary Calculi . Diagnosis of hyperparathyroidism is based on the presence of an elevated PTH level in patients with hypercalcemia. In patients with elevated levels of PTH, further studies are needed, including measurement of calcium and phosphorus levels and imaging to evaluate bone density and determine the presence of kidney stones. Treatment is usually surgical removal of the affected parathyroid gland. Parathyroid surgery should done by a surgeon experienced in operating on the parathyroid glands. Localization of parathyroid tissue before surgery on the parathyroid(s) is sometimes done, especially when minimally invasive surgery is planned. Several techniques have been used, and all are highly accurate: High-resolution CT with or without CT-guided biopsy MRI High-resolution ultrasonography Digital subtraction angiography Thallium-201–technetium-99 scanning Technetium-99 sestamibi, a radionuclide agent for parathyroid imaging, is more sensitive and specific than older agents and may be useful for identifying solitary adenomas. Occasionally, the calcimimetic,cinacalcet, is given to decrease secretion of PTH. 