Citation Information :
de Jong MC, Shawky M, García VR, Kurzawinski TR, Abdel-Aziz TE. Parathyroid Carcinoma in a Center Routinely Using ioPTH: A Case Series. World J Endoc Surg 2019; 11 (2):57-59.
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.
Obara T, Fujimoto Y. Diagnosis and treatment of patients with parathyroid carcinoma: an update and review. World J Surg 1991;15(6):738–744. DOI: 10.1007/BF01665308.
Wang P, Xue S, et al. Clinical characteristics and treatment outcomes of parathyroid carcinoma: A retrospective review of 234 cases. Oncol Lett 2017;14(6):7276–7282. DOI: 10.3892/ol.2017.7076.
Busaidy NL, Jimenez C, et al. Parathyroid carcinoma: a 22-year experience. Head Neck 2004;26(8):716–726. DOI: 10.1002/hed. 20049.
Pelizzo MR, Piotto A, et al. Parathyroid carcinoma. Therapeutic strategies derived from 20 years of experience. Minerva Endocrinol 2001;26(1):23–29.
Ricci G, Assenza M, et al. Parathyroid carcinoma: the importance of high clinical suspicion for a correct management. Int J Surg Oncol 2012;2012:649148. DOI: 10.1155/2012/649148.
Ryhanen EM, Leijon H, et al. A nationwide study on parathyroid carcinoma. Acta Oncol 2017;56(7):991–1003. DOI: 10.1080/0284186X.2017.1306103.
Wynne AG, van Heerden J, et al. Parathyroid carcinoma: clinical and pathologic features in 43 patients. Medicine (Baltimore) 1992;71(4):197–205. DOI: 10.1097/00005792-199207000-00002.
Shane E, Bilezikian JP. Parathyroid carcinoma: a review of 62 patients. Endocr Rev 1982;3(2):218–226. DOI: 10.1210/edrv-3-2-218.
Christakis I, Bussaidy N, et al. Differentiating Atypical Parathyroid Neoplasm from Parathyroid Cancer. Ann Surg Oncol 2016;23(9): 2889–2897. DOI: 10.1245/s10434-016-5248-6.
Bae JH, Choi HJ, et al. Preoperative predictive factors for parathyroid carcinoma in patients with primary hyperparathyroidism. J Korean Med Sci 2012;27(8):890–895. DOI: 10.3346/jkms.2012.27.8.890.
Solorzano CC, Carneiro-Pla DM, et al. Intra-operative parathyroid hormone monitoring in patients with parathyroid cancer. Ann Surg Oncol 2007;14(11):3216–3222. DOI: 10.1245/s10434-007-9590-6.
Piciu D, Irimie A, et al. Highly aggressive pathology of non-functional parathyroid carcinoma. Orphanet J Rare Dis 2013;8:115. DOI: 10.1186/1750-1172-8-115.
Suganuma N, Iwasaki H, et al. Non-functioning parathyroid carcinoma: a case report. Surg Case Rep 2017;3(1):81. DOI: 10.1186/s40792-017-0357-4.
Schantz A, Castleman B. Parathyroid carcinoma. A study of 70 cases. Cancer 1973;31(3):600–605. DOI: 10.1002/1097-0142(197303)31: 3<600::AID-CNCR2820310316>3.0.CO;2-0.