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Most parathyroid adenomas involve one of the lower glands (75% of cases). About 10% involve one of the upper glands. A small number of cases involve parathyroids in anomalous locations, including mediastinum (usually thymus), intrathyroidal, tracheo-esophageal groove, paraesophageal, or carotid sheath. The genetic syndromes associated with familial primary hyperparathyroidism include: Multiple Endocrine Neoplasia 1 (inactivation of MEN 1 gene on chromosome 11q13); Multiple Endocrine Neoplasia 2 (activating mutations in the tyrosine kinase receptor, RET, on chromosome 10q); Familial Hypocalciuric Hypercalcemia (inactivating mutations in parathyroid calcium-sensing receptor gene, CASR, on chromosome 3q.