Treatment options for parathyroid disorders
December 01, 2012
Problems involving the parathyroid glands can be treated at UC Irvine Medical Center with minimally invasive surgery and intraoperative hormone monitoring—an
innovative combination that offers many benefits.
The parathyroids are four tiny glands each about the size of a grain of rice,
located below the neck, underneath the thyroid gland. They are part of the
endocrine system, which controls major processes including growth, metabolism and
reproduction. By producing parathyroid hormone (PTH), these glands play an
important role in controlling the level of calcium in the blood. This level must
stay within a very narrow range, because calcium levels affect bone health as
well as proper nerve and muscle function.
Disorders of the parathyroid glands cause too much PTH to be produced.
“Hyperparathyroidism” arises from uncontrolled cellular growth. This can
result in either a benign (noncancerous) tumor in one gland, a general enlargement
of glands, or multiple tumors in one or more glands. Most growths are benign,
with parathyroid cancers accounting for only 1 percent of cases. Yet even benign
growths can cause serious problems because they disrupt normal calcium metabolism.
A malfunctioning parathyroid can lead to painful kidney stones, as well as pain
in the bones and stomach. In fact, “stones, bones and groans”
is the phrase medical students use to identify the symptoms commonly caused by
Surgery is generally needed to remove enlarged parathyroid glands. Traditional
surgery requires a large incision, and involves a certain amount of trauma while
the parathyroids are located and tested. Today, minimally invasive
parathyroid surgery offers patients a less traumatic operation with excellent
results. At UC Irvine Medical Center, this surgery is combined with
intraoperative PTH monitoring, which indicates exactly when all the problematic
tissue has been removed.
To begin, the patient receives an injection of a radioactive isotope called
sestamibi. Next, a PET scan is performed to reveal which of the parathyroid
glands are involved, and to identify their locations. During surgery, the
first affected gland is removed, and the patient’s blood is quickly tested
to see if the PTH level is reduced. If not, additional glands may be taken out.
In 85 percent of cases, only a single gland is affected, meaning that only a
small incision is required. Minimally invasive surgery permits more rapid
recovery, reduces the risk of complications and leaves a smaller scar.
Learn more about Dr. Butler ›