Difference Between Parathyroid Adenoma and Parathyroid Hyperplasia

A peptide hormone secreted by the parathyroid gland that helps in the concentration of the serum calcium, which affects kidneys, bones, intestines etc., is called Parathyroid hormone (PTH). PTH also helps in the process of bone remodelling, where the process continues. Bone tissues are rebuilt and reabsorbed. PTH is the chief gland that is secreted by the parathyroid.

There are two types of PTH receptors i.e. Parathyroid hormone 1 receptor and Parathyroid hormone 2 receptors. Parathyroid adenoma and Parathyroid hyperplasia are the two types of diseases that are caused by excessive secretion of PTH.

Parathyroid Adenoma vs Parathyroid Hyperplasia

The main difference between Parathyroid Adenoma and Parathyroid Hyperplasia is that Parathyroid Adenoma affects only one gland at a time. While Parathyroiud Hyperplasia affects multiple glands at the same time. Parathyroid Adenoma is a tumour that is usually caused by hyperparathyroidism. Parathyroid Hyperplasia is a condition where there is an enlargement of the tissue or organs that are sometimes confused with the tumour. Treatment of Parathyroid Adenoma can only be done using surgery. Treatment of Parathyroid Hyperplasia depends upon the type.

Parathyroid Adenoma vs Parathyroid Hyperplasia

Parathyroid Adenoma is a benign tumour meaning that the tumour cannot spread to other parts. It is a non-malignant tumour caused by hyperparathyroidism. PTH gland is responsible for causing it. Sometimes hyperparathyroidism may not be the reason for it. But when hyperparathyroidism is responsible for causing Parathyroid Adenoma, then PTH is secreted more than in turns causes to increase in the concentration of calcium in the blood resulting in a condition called hypercalcemia. Signs of Parathyroid Adenoma may include urinary calculi and bone fracture.

Parathyroid Hyperplasia causes an increase in organ tissues, and sometimes when there is a massive enlargement, it may be related to a benign tumour or neoplasia. When seen from the microscope, in this condition, cells appear normal, but there is an increase in the number, and sometimes size also increases, called hypertrophy. Causes of Parathyroid Hyperplasia include a chronic inflammatory response, hormonal dysfunctions, skin loss, compensation for damage or disease elsewhere. Sometimes Hyperplasia may be completely normal and harmless.

Comparison Table Between Parathyroid Adenoma and Parathyroid Hyperplasia

Parameters of ComparisonParathyroid AdenomaParathyroid Hyperplasia
FieldOncologyPathology
CausesGenetic disorders, Lithium drugs, and Chronic kidney disease.Isolated familial hyperparathyroidism, Multiple endocrine neoplasia type I, Multiple endocrine neoplasia types II etc.
TreatmentSurgeryDepending upon the type
Diagnosis Blood Tests, Sestamibi parathyroid scintigraphy, the sestamibi scan etc.Biopsy
AffectsOnly one glandAll four glands

What is Parathyroid Adenoma?

Parathyroid Adenoma can be caused by a genetic condition like the overexpression of the cyclin D1 gene. It can also be caused by multiple endocrine neoplasias (MEN). Symptoms of Parathyroid Adenoma may include kidney stones and bone fractures. Often this disease is found out when there is a blood test check-up that reveals the increased calcium levels. Patients suffering from adenoma may not be showing any symptoms, but secretly their PTH glands must be secreting excessive amounts of calcium. If it is left untreated, then it may cause problems in old age.

But in symptomatic conditions, patients may experience a lot of symptoms like pain in muscles, abdomen, joints, hormonal imbalance, depression, mood swings, exhaustion, constipation, kidney damage etc. Parathyroid Adenoma leads to another condition, Hyperparathyroidism. Tests for Adenoma is specifically designed called the sestamibi scan, where nuclear imaging technique is used that tells the location and presence of parathyroid tissue.

Surgery is considered the best option for treating Parathyroid adenoma. Because its succession rate is 95%. Parathyroidectomy is done to remove the gland that is affected by Adenoma.

What is Parathyroid Hyperplasia?

Hyperplasia is an ancient Greek word meaning over formation/. Parathyroid Hyperplasia is the enlargement of the tissues. It is caused due to cell proliferation, where cell grows and divides. When there is an increase in the number of cells, then hyperplasia is caused. There are many causes through which it can happen skin loss, chronic inflammatory response, hormonal dysfunctions, or compensation for damage or disease elsewhere. Sometimes Hyperplasia can be completely harmless. It may grow on a particular tissue. Like in breast preparing for future breastfeeding.

IGF or Insulin Growth hormone can cause hyperplasia to increase the number of muscle cells present in the human tissues. Theories suggest that hyperplasia can also be caused due to specific weight training that can cause cells to mature in size and strength. Hyperplasia is a physiological response that can happen due to stimuli and can be controlled by using normal mechanisms. But if it happens due to pathological response, then it becomes necessary for stimuli to be removed.

Types of Hyperplasia include Congenital adrenal hyperplasia, Benign prostatic hyperplasia, Sebaceous hyperplasia, Hemihyperplasia, Intimal hyperplasia, Endometrial hyperplasia, Hyperplasia of the breast etc.

Main Differences Between Parathyroid Adenoma and Parathyroid Hyperplasia

  1. Parathyroid Adenoma belongs to the field of Oncology. Parathyroid Hyperplasia belongs to the field of pathology.
  2. Causes of Parathyroid Adenoma are Genetic disorders, Lithium drugs, and Chronic kidney disease. Causes of Parathyroid Hyperplasia are Isolated familial hyperparathyroidism, Multiple endocrine neoplasia type I, Multiple endocrine neoplasia types II etc.
  3. Treatment of Parathyroid Adenoma is surgery that is successful most of the time. Treatment of Parathyroid hyperplasia depends upon the type of hyperplasia.
  4. Diagnosis of Parathyroid Adenoma includes Blood Tests, Sestamibi parathyroid scintigraphy, sestamibi scan etc. Diagnosis of Parathyroid Hyperplasia includes Biopsy.
  5. Parathyroid Adenoma affects only one gland. Parathyroid Hyperplasia affects all four glands at the same time.

Conclusion

Both Parathyroid Adenoma and parathyroid hyperplasia happen due to the excessive secretion of PTH. Both can cause the condition of hyperparathyroidism. Both can have the same symptoms like lethargy, constipation, weakness in bones etc. Both of them can be treated using surgical methods.

In parathyroid adenoma, surgery is easy as one gland can be removed without disturbing others. Whereas in Parathyroid Hyperplasia, surgery becomes complicated since more numbers of glands are there. It depends upon the surgeon which gland will be removed depending upon the abnormal calcium levels. In these usually, three to five glands are removed. Both the disease can lead to the weight gaining of the patient.

References

  1. https://link.springer.com/content/pdf/10.1007/s12105-008-0088-8.pdf
  2. https://www.sciencedirect.com/science/article/pii/S1055320718302424
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