Watch out for parathyroid adenoma with elevated blood calcium

  For eight years, Hangzhou’s Wang Da Ma always felt back pain and had kidney stones several times, but never found the cause, unexpectedly suffered from parathyroid tumor.   According to Ding Jinwang, attending physician of oncology surgery at Hangzhou First People’s Hospital, there are generally four rice-sized parathyroid glands growing next to the thyroid gland of each person. Once the parathyroid gland grows a tumor, it will lead to elevated blood calcium, osteoporosis, repeated urinary stones, etc., which can seriously lead to fracture, kidney failure and even uremia. Once the public finds elevated blood calcium and recurrent urinary stones, they must pay attention.  The reason for the recurring double kidney stones cannot be found 78-year-old Wang Da Ma, who lives in the south of Hangzhou, is a retired employee. Since retirement, Wang’s body has been suffering from minor ailments and pains, as well as years of diabetes. In particular, in the past seven or eight years, she always felt back pain and often felt joint pain, and went to the hospital for examination and found that Wang had symptoms of osteoporosis. The doctor told her that osteoporosis is a common disease among the elderly and that she should strengthen her nutrition and take more calcium.  Not only that, but Wang’s kidneys also appeared abnormal, suffering from kidney stones several times in recent years. Each time, she went to the hospital for extracorporeal lithotripsy treatment, but it didn’t take long to go for a physical examination and find that stones had grown in her kidneys again.   The family members were terrified when they found out, and rushed her to a hospital in Hangzhou to have an ultrasound examination, which showed that Wang’s ureter was full of stones on both sides and also had a hydronephrosis. The symptoms were gradually relieved after a ureteral endoscopic stone extraction surgery.  A month later, Wang went to the hospital for a follow-up examination, but unexpectedly checked that the calcium index was high, and the parathyroid hormone index was also seriously over the limit. The normal parathyroid hormone indicator is between 7 and 53 ng/L, but Wang’s indicator is as high as 225 ng/L, which is several times over the limit.  The actual fact is that there are more parathyroid tumors in women than in men. The blood calcium is elevated and so are the parathyroid hormones.   ”The parathyroid glands generally have four, each about the size of a grain of rice. They are oval or flat oval in shape, yellow, brown or yellowish-brown in appearance, and mainly distributed in the posterior medial region of the thyroid gland.” Ding Jinwang, attending physician of oncology surgery of Hangzhou First Hospital, said that parathyroid tumor is a special kind of endocrine system tumor, which mainly secretes parathyroid hormone. The clinical incidence is low, but in recent years the incidence has been on a gradual rise. It has been reported that the disease can occur at any age, but is generally more common in 20 to 50 years old, with more women than men, about 2-3:1. It is understood that the pathological types of parathyroid tumors can be divided into: parathyroid adenoma, parathyroid cyst and parathyroid cancer. Most of them can cause hyperparathyroidism, except for nonfunctional parathyroid cysts. Among patients with primary hyperparathyroidism, 85% of cases are single parathyroid adenomas, 5% are multiple parathyroid adenomas, 10% are parathyroid hyperplasia, and parathyroid cancer accounts for less than 1% of cases.  According to statistics, the number of parathyroid tumor cases admitted to the Department of Oncology of Hangzhou First Hospital in the past four years is 20, 17 for female patients and 3 for male patients, of which only one case is parathyroid cancer and the rest are benign.