Parathyroid cancer

Facts

Parathyroid cancer is very rare. Most cases of parathyroid disease, including almost all cases of overactive parathyroid, are not cancer. At Fred Hutchinson Cancer Center, our endocrine tumor specialists — all UW Medicine doctors — have experience evaluating and treating people whose disease is cancer related.

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What is parathyroid cancer?

You have 4 parathyroid glands in your neck — 2 near each half of your thyroid gland. Normally each parathyroid gland is about the size of a grain of rice. They make and release parathyroid hormone (PTH), which helps maintain a healthy level of calcium in your blood.

Cancer in a parathyroid gland usually causes a high level of PTH (overactive parathyroid, or hyperparathyroidism). This leads to a high level of calcium in your blood (hypercalcemia). High blood calcium can be dangerous, and it requires treatment.

Typically cancer develops in only 1 of the 4 parathyroid glands.

Symptoms

Hypercalcemia from parathyroid cancer can lead to a range of symptoms. But the symptoms are not always obvious. They can include:

Tiredness
Weakness
Frequent urination
Increased thirst
Nausea and vomiting
Constipation
Loss of appetite
Unexplained weight loss
Trouble thinking
Bone pain

If cancer causes a parathyroid gland in your neck to grow, you may have somewhat different symptoms, such as these:

Lump in the neck
Hoarseness
Trouble swallowing or speaking
Shortness of breath

Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.

Diagnosing

If your doctor suspects you might have parathyroid cancer, the doctor will examine you, ask about your medical history and ask for tests, such as:

Blood tests — including tests to check the level of parathyroid hormone and calcium in your blood
Imaging studies — such as a radionuclide (sestamibi) parathyroid scan, computed tomography (CT) scan or ultrasound
Genetic testing — to check for mutations that are common in people with parathyroid cancer

Computed tomography A procedure that uses a computer linked to an X-ray machine to make a series of detailed pictures of areas inside the body. The pictures are used to create three-dimensional (3-D) views of tissues and organs. A procedure that uses a computer linked to an X-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create three-dimensional (3-D) views of tissues and organs. A dye may be injected into a vein or swallowed to help the tissues and organs show up more clearly. This scan may be used to help diagnose disease, plan treatment or find out how well treatment is working. Genetic testing Tests that can be done to see if a person has certain gene changes known to increase cancer risk. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Ultrasound A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen. A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen (sonogram). Ultrasound may be used to help diagnose diseases, such as cancer. It may also be used during pregnancy to check the fetus (unborn baby) and during medical procedures, such as biopsies. Also called ultrasonography.

Risk factors

Most of the time, there’s no clear cause for parathyroid cancer. The following inherited disorders may increase your risk:

Familial isolated hyperparathyroidism (FIPH), in which parathyroid tumors lead to excess parathyroid hormone
Hyperparathyroidism-jaw tumor syndrome, which causes overactive parathyroid glands and tumors that usually are benign but sometimes are cancerous
Multiple endocrine neoplasia, which can affect the parathyroid glands as well as other glands that make hormones

Having radiation therapy to your neck can also increase your risk for parathyroid cancer.

Benign Not cancer. Benign tumors may grow larger but do not spread to other parts of the body. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body.

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