Hyperfunctioning supernumerary parathyroid glands. An occasional cause of hyperparathyroidism

Area of Science:

• Endocrinology
• Surgical Pathology
• Medical Reviews

Background:

• Primary hyperparathyroidism is typically caused by abnormalities in the four standard parathyroid glands.
• Supernumerary parathyroid glands, though rare, are an underappreciated cause of parathyroid hormone (PTH) excess.
• Understanding the clinical presentation and management of hyperfunctioning fifth parathyroid glands is crucial for accurate diagnosis and treatment.

Observation:

• This review analyzes 15 patients with hyperparathyroidism due to a hyperfunctioning fifth parathyroid gland.
• Patients exhibited clinical and pathological features similar to those with primary hyperparathyroidism.
• A significant observation was the frequent mediastinal location of these supernumerary gland tumors.

Findings:

• Hyperfunctioning fifth parathyroid glands can lead to hyperparathyroidism with typical disease complications.
• The pathology and post-surgical care for these rare cases mirror standard primary hyperparathyroidism management.
• The majority of fifth gland tumors were found in the mediastinum, distinguishing them from common parathyroid adenomas.

Implications:

• Clinicians should consider supernumerary glands in cases of unexplained hyperparathyroidism, especially with mediastinal masses.
• Diagnostic strategies may need to be adapted to detect ectopic or supernumerary parathyroid tissue.
• Surgical approaches should account for the potential mediastinal location of hyperfunctioning fifth parathyroid glands.