Parathyroid disease is rare. But, as an academic medical center, we see more cases than any provider in the South Florida region. If you or a loved one are diagnosed with parathyroid disease, contact us for immediate access to our experienced care team.
Sylvester Comprehensive Cancer Center can ensure an accurate diagnosis between primary parathyroid disease, secondary parathyroid disease, and parathyroid cancer. Our team of physician experts, endocrinologists, surgeons, oncologists, radiologists, and pathologists will evaluate and plan treatment for your exact condition.
Because it's very rare, parathyroid cancer doesn’t use a staging system and describes the tumor as:
- Localized parathyroid cancer: Found in a parathyroid gland and possibly in nearby tissues
- Metastatic parathyroid cancer: Has spread to another part of the body, such as the bones, liver, lungs, lymph nodes or other areas
- Recurrent parathyroid cancer: Cancer that's come back after treatment
Test
Ultrasound Exam of the Neck
Ultrasound uses high-energy sound waves, which bounce off internal tissues or organs to form a picture (sonogram).
Magnetic Resonance Imaging (MRI)
In cases where ultrasound, sestamibi, and high-resolution CT scans are negative or in re-operative parathyroid surgery, MRI may occasionally be used.
Sestamibi Scan
This is a type of radionuclide scan used to find an overactive parathyroid gland. A very small amount of a radioactive substance (technetium 99) is injected into your vein, and it travels through your bloodstream to the parathyroid glands. The radioactive substance will collect in an overactive gland and show up brightly on a special camera that detects radioactivity
Single Photon Emission Computed Tomography (SPECT) Scan
This procedure creates a 3-D picture using a special camera linked to a computer. You receive an injection of a small amount of a radioactive substance. As the substance travels through your bloodstream, the camera rotates around your neck and takes pictures. Blood flow and metabolism are higher in areas affected by cancer, which show up brighter in the pictures.
High-Resolution CT Scan (4-D CT Scan)
This test looks for abnormal parathyroid glands. It has a 95 percent accuracy rate for identifying abnormal parathyroid glands — far superior to a standard CT scan. You receive a contrast dye as an injection, which travels through your bloodstream and into your parathyroid glands. The health of your glands is determined by their size and how quickly the dye washes in and out of your glands..
Parathyroid Fine-Needle Biopsy
This procedure takes a sample of a nodule that may be a sign of an abnormal parathyroid gland. It also measures your parathyroid hormone levels. It's done using a small needle guided by ultrasound imaging.
Miami Criterion
If imaging doesn’t show which parathyroid gland is involved, your doctor may use this surgical technique to narrow it down. The Miami Criterion, which was pioneered at UHealth, allows surgeons to test which parathyroid gland is over-secreting parathyroid hormone and remove only that gland (or glands) through a tiny incision.
Treatments
Hormone Replacement
For women who’ve gone through menopause and have signs of osteoporosis, hormone replacement therapy may help bones retain calcium.
Subtotal Parathyroidectomy
This surgery involves removal of part of the parathyroid gland, leaving some functioning tissue.
PTH-Guided Parathyroidectomy
In this surgery, the surgeon removes enough parathyroid tissue to bring the parathyroid hormone (PTH) levels to between 200 and 300.
Focused Parathyroidectomy
This technique allows your surgeon to test which parathyroid gland is over-secreting parathyroid hormone and remove only that gland through a tiny incision. The procedure, called the Miami Criterion, was developed by a Sylvester Comprehensive Cancer Center surgeon and it’s used worldwide.
Surgery
Surgery is the best option to treat parathyroid cancer. Our surgeons remove the cancer, the thyroid lobe, and any other structures affected by cancer.
By the time parathyroid cancer is found, typically it's grown into surrounding structures like the muscle and thyroid lobe. People with parathyroid cancer often have very high parathyroid hormone levels, usually more than five times the upper limit of normal values; and very high calcium levels (often higher than 13 to 14 mg/dL).
After the procedure, you're followed closely with blood tests and imaging tests at regularly scheduled times. We look for any cancer recurrence (cancer coming back). If there’s a recurrence, most patients will have another surgery to remove as much of the cancer as possible. You may also be started on a medication called cinacalcet, which tricks the body into lowering the blood calcium levels.
While parathyroid cancer is rare, more than half of people with this type of cancer have a recurrence after treatment. It usually recurs between two and five years after the first surgery. It can recur up to 20 years later, usually in the tissues or lymph nodes of the neck. The first sign of recurrence is often high blood calcium levels.
Why Choose Sylvester Comprehensive Cancer Center?
Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.
Only center in South Florida with a specialty endocrine testing center. Our specialized testing centers improves diagnosis accuracy, leading to more precise treatments and better results. Located at the University of Miami Miller School of Medicine, the center is staffed by specialized nurses and technical assistants who perform complex hormone tests.
Leading-edge radiation therapy technology. From our pioneering work in MRI-guided techniques and HyperArc™ radiosurgery to our new addition of proton beam therapy, we can precisely target cancer cells with utmost accuracy. We offer advanced treatment options, including intensity-modulated radiation therapy, stereotactic body radiation therapy, stereotactic radiosurgery, and more, to improve outcomes, while preserving healthy organs and tissues.
More cancer clinical trials than any other South Florida hospital. If appropriate for your cancer and stage, our clinical trials provide you with easy access to the newest ways to treat and potentially cure your cancer.
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