Surgery Today

, Volume 41, Issue 2, pp 237–241 | Cite as

Use of a gamma probe to identify and guide resection of recurrent parathyroid carcinoma: Report of a case

  • Ricardo Pedrini Cruz
  • Alexandre Vontobel Padoin
  • Daniel Weiss Vilhordo
  • Anselmo Hoffmann
  • Cláudio Corá Mottin
Case Report
  • 65 Downloads

Abstract

Parathyroid carcinoma (PC) accounts for less than 0.005% of all cancers and less than 5% of causes of hyperparathyroidism. This tumor is difficult to identify during surgery, which is detrimental to the oncologic results. Surgery is still the main treatment for the primary tumor and to control parathyroid hormone levels after recurrence. We report a case of recurrent parathyroid carcinoma in a 30-year-old man, identified and managed with the use of a gamma probe during surgery. To our knowledge, this is only the second report of a gamma probe being used to guide resection of a recurrent PC. We discuss the diagnosis and treatment, analyzing the current evidence-based literature.

Key words

Parathyroid carcinoma Hyperparathyroidism Parathyroid tumor Hypercalcemia En bloc resection Gamma probe 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Schantz A, Castleman B. Parathyroid carcinoma. A study of 70 cases. Cancer 1973;31:600–605.CrossRefPubMedGoogle Scholar
  2. 2.
    Clayman GL, Gonzalez HE, El-Naggar A, Vassilopoulou-Sellin R. Parathyroid carcinoma: evaluation and interdisciplinary management. Cancer 2004;100:900–905.CrossRefPubMedGoogle Scholar
  3. 3.
    Munson ND, Foote RL, Northcutt RC, Tiegs RD, Fitzpatrick LA, Grant CS, et al. Parathyroid carcinoma: is there a role for adjuvant radiation therapy? Cancer 2003;98:2378–2384.CrossRefPubMedGoogle Scholar
  4. 4.
    Kebebew E. Parathyroid carcinoma. Curr Treat Options Oncol 2001;2:347–354.CrossRefPubMedGoogle Scholar
  5. 5.
    Rawat N, Khetan N, Williams DW, Baxter JN. Parathyroid carcinoma. Br J Surg 2005;92:1345–1353.CrossRefPubMedGoogle Scholar
  6. 6.
    Fujimoto Y, Obara T, Ito Y, Kanazawa K, Aiyoshi Y, Nobori M. Surgical treatment of ten cases of parathyroid carcinoma: Importance of an initial en bloc tumor resection. World J Surg 1984;8:392–400.CrossRefPubMedGoogle Scholar
  7. 7.
    Shane E. Clinical review 122: parathyroid carcinoma. J Clin Endocrinol Metab 2001;86:485–493.CrossRefPubMedGoogle Scholar
  8. 8.
    Koea JB, Shaw JHF. Parathyroid cancer: biology and management. Surg Oncol 1999;155–165.Google Scholar
  9. 9.
    Jakoubkova S, Vokurka J, Cáp J, Ryska A. Parathyroid carcinoma: clinical presentation and treatment. International Congress Series 1240 2003;991–995.Google Scholar
  10. 10.
    Thompson SD, Prichard AJN. The management of parathyroid carcinoma. Curr Opin Otolaryngol Head Neck Surg 2004;12:93–97.CrossRefPubMedGoogle Scholar
  11. 11.
    Kirkby-Bott J, Lewis P, Harmer CL, Smellie WJB. One stage treatment of parathyroid cancer. Eur J Surg Oncol 2005;31:78–83.CrossRefPubMedGoogle Scholar
  12. 12.
    Kebebew E, Arici C, Duh QY, Clark OH. Localization and reoperation results for persistent and recurrent parathyroid carcinoma. Arch Surg 2001;136:878–885.CrossRefPubMedGoogle Scholar
  13. 13.
    Dotzenrath C, Goretzki PE, Sarbia M, Cupisti K, Feldkamp J, Roher HD. Parathyroid carcinoma: problems in diagnosis and the need for radical surgery even in recurrent disease. EJSO 2001;27:383–389.CrossRefPubMedGoogle Scholar
  14. 14.
    Hundahl SA, Fleming ID, Fremgen AM, Menck HR. Two hundred eighty-six cases of parathyroid carcinoma treated in the US between 1985 and 1995. A national cancer data report. Cancer 1999;86:538–544.CrossRefPubMedGoogle Scholar
  15. 15.
    Fraker DL. Update on the management of parathyroid tumors. Curr Opin Oncol 2000;12:41–48.CrossRefPubMedGoogle Scholar
  16. 16.
    Flye MW, Brennan MF. Surgical resection of metastatic parathyroid carcinoma. Ann Surg 1981;193:425–435.CrossRefPubMedGoogle Scholar
  17. 17.
    Cohn K, Silverman M, Corrado J, Sedgewick C. Parathyroid carcinoma: the Lahey Clinic experience. Surgery 1985;98:1095–1100.PubMedGoogle Scholar
  18. 18.
    Obara T, Fujimoto Y. Diagnosis and treatment of patients with parathyroid carcinoma: an update and review. World J Surg 1991;15:738–744.CrossRefPubMedGoogle Scholar
  19. 19.
    Aldinger AK, Hickey RC, Ibanez ML, Samaan NA. Parathyroid carcinoma: a clinical study of seven cases of functioning and two cases of nonfunctioning parathyroid cancer. Cancer 1982;49:388–397.CrossRefPubMedGoogle Scholar
  20. 20.
    Shattuck TM, Välimäki S, Obara T, Gaz RD, Clark OH, Shoback D, et al. Somatic and germ-line mutations of the HRPT2 gene in sporadic parathyroid carcinoma. N Engl J Med 2003;349(18):1722–1729.CrossRefPubMedGoogle Scholar
  21. 21.
    Whitson BA, Broadie TA. Preoperative ultrasound and nuclear medicine studies improve the accuracy in localization of adenoma in hyperparathyroidism. Surg Today 2008;38(3):222–226.CrossRefPubMedGoogle Scholar
  22. 22.
    Placzkowski K, Christian R, Chen H. Radioguided parathyroidectomy for recurrent parathyroid cancer. Clin Nucl Med 2007;32(5):358–360.CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2011

Authors and Affiliations

  • Ricardo Pedrini Cruz
    • 1
    • 2
  • Alexandre Vontobel Padoin
    • 1
  • Daniel Weiss Vilhordo
    • 1
  • Anselmo Hoffmann
    • 1
  • Cláudio Corá Mottin
    • 1
  1. 1.Serviço de Cirurgia Geral, Ambulatório de Cirurgia EndocrinológicaHospital São Lucas da Pontifícia Universidade Católica do Rio Grande do SulPorto Alegre, RSBrazil
  2. 2.Porto AlegreRS, Brazil

Personalised recommendations