Other rare parathyroid problems

Parathyroid Cancer

Parathyroid cancer is EXTREMELY rare and is almost NEVER the cause of hyperparathyroidism. In fact, each year in the United States, only a few dozen cases are seen. It is so rare that most doctors will go their entire career without seeing a single case of it. It is difficult to predict which patients have parathyroid cancer, but a rule of thumb is that parathyroid cancer will usually produce very, very high levels of PTH (in the thousands), as opposed to levels in the hundreds seen with primary hyperparathyroidism. Also, parathyroid cancer is typically associated with a genetic defect – multiple endocrine neoplasia (MEN syndrome) – and runs in families. The treatment is the same as regular hyperparathyroidism – surgical removal of the gland with additional removal of any lymph nodes in the neck that may have metastatic disease. Again, we cannot overemphasize how rare parathyroid cancer is and the fact is you should NOT be worried about it.

Hypoparathyroidism

Hypoparathyroidism (or LOW levels of PTH) is an uncommon and unfortunate result of thyroid and parathyroid surgery in some patients. It occurs when the surgeon unintentionally removes or injures all four parathyroid glands and results in the body being unable to produce any parathyroid hormone. As you can imagine, this results in LOW calcium levels and high levels of phosphate (PTH is also responsible for ridding the body of phosphate). The symptoms can be similar to hypercalcemia and include tingling in the extremities, muscle cramps, and even convulsions. In our experience, hypoparathyroidism is only seen in patients where the surgeon performed less than one parathyroid operation per week (often even less than one per month). In the hands of an experienced parathyroid surgeon, hypoparathyroidism is nearly nonexistent.