Aim: Parathyroid carcinoma (PC) is a rare endocrine malignancy and therefore limited data are currently available. In this case series, we describe our institution\'s experience with PC and patients’ outcomes.
Background: The course of PC ranges from indolent to progressive disease with an uncontrollable hypercalcemia and widespread metastases. No clear guidelines toward diagnosis as well as management currently exist owing to a lack of prospective data.
Case description: Here, we present a case series of 12 patients who underwent treatment for PC at our institution. All patients were diagnosed after surgery. At time of surgery, three patients (25.0%) underwent a concomitant hemithyroidectomy owing to abnormal features. An additional four patients (33.3%) underwent a hemithyroidectomy on the side of their PC. None of our patients received any adjuvant medical therapy. One patient (8.3%) was found to have recurrent disease; this patient is currently alive with disease.
Conclusion: In conclusion, although no uniform management strategy was observed during the included period, overall outcomes were good, with a recurrence rate of less than 10%.
Clinical significance: PC is a very uncommon malignancy that imposes both diagnostic and management uncertainties. The current report describes the management and outcomes of a series of 12 patients with this disease. All patients were only diagnosed after surgery as having a PC. Moreover, possibly due to a lack of prospective data, all patients in our series underwent different surgical treatment strategies. Nonetheless, overall, both short- and long-term outcomes were satisfactory, with a less than 10% recurrence rate. However, this series does underline the importance of more prospective research regarding diagnostic, treatment, and prognostic variables for PC.
Sainton P, Millot J. Malegne dun adenoma parathyroidiene eosinophile; au cours de Recklinghausen. Ann Anat Pathol 1933;10:813.
Sharretts JM, Kebebew E, et al. Parathyroid cancer. Semin Oncol 2010;37(6):580–590. DOI: 10.1053/j.seminoncol.2010.10.013.
Schulte KM, Talat N. Diagnosis and management of parathyroid cancer. Nat Rev Endocrinol 2012;8(10):612–622. DOI: 10.1038/nrendo.2012.102.
McClenaghan F, Qureshi YA. Parathyroid cancer. Gland Surg 2015;4(4):329–338.
Barczynski M, Konturek A, et al. Evaluation of Halle, Miami, Rome, and Vienna intraoperative iPTH assay criteria in guiding minimally invasive parathyroidectomy. Langenbecks Arch Surg 2009;394(5):843–849. DOI: 10.1007/s00423-009-0510-z.
Adam MA, Untch BR, et al. Parathyroid carcinoma: current understanding and new insights into gene expression and intraoperative parathyroid hormone kinetics. Oncologist 2010;15(1):61–72. DOI: 10.1634/theoncologist.2009-0185.