World Journal of Endocrine Surgery

Register      Login

VOLUME 11 , ISSUE 2 ( May-August, 2019 ) > List of Articles

CASE REPORT

Parathyroid Carcinoma in a Center Routinely Using ioPTH: A Case Series

Mechteld C de Jong, Michael Shawky, Virginia Rozalén García, Tom R Kurzawinski, Tarek E Abdel-Aziz

Keywords : Management, Outcomes, Parathyroid carcinoma, PTH

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.

DOI: 10.5005/jp-journals-10002-1261

License: CC BY-NC 4.0

Published Online: 01-11-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

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.


HTML PDF Share
  1. Sainton P, Millot J. Malegne dun adenoma parathyroidiene eosinophile; au cours de Recklinghausen. Ann Anat Pathol 1933;10:813.
  2. Sharretts JM, Kebebew E, et al. Parathyroid cancer. Semin Oncol 2010;37(6):580–590. DOI: 10.1053/j.seminoncol.2010.10.013.
  3. Schulte KM, Talat N. Diagnosis and management of parathyroid cancer. Nat Rev Endocrinol 2012;8(10):612–622. DOI: 10.1038/nrendo.2012.102.
  4. McClenaghan F, Qureshi YA. Parathyroid cancer. Gland Surg 2015;4(4):329–338.
  5. 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.
  6. 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.
  7. Shane E. Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab 2001;86(2):485–493. DOI: 10.1210/jcem.86.2.7207.
  8. 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.
  9. 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.
  10. Busaidy NL, Jimenez C, et al. Parathyroid carcinoma: a 22-year experience. Head Neck 2004;26(8):716–726. DOI: 10.1002/hed. 20049.
  11. Koea JB, Shaw JH. Parathyroid cancer: biology and management. Surg Oncol 1999;8(3):155–165. DOI: 10.1016/S0960-7404(99)00037-7.
  12. Pelizzo MR, Piotto A, et al. Parathyroid carcinoma. Therapeutic strategies derived from 20 years of experience. Minerva Endocrinol 2001;26(1):23–29.
  13. 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.
  14. 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.
  15. 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.
  16. 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.
  17. 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.
  18. 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.
  19. 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.
  20. 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.
  21. 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.
  22. 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.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.