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Seven cases of parathyroid carcinoma and review of the literature

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Parathyroid cancer is a rare malignancy and an uncommon cause of hyperparathyroidism. In the present study, we present seven cases of parathyroid carcinoma. The female ratio was 5/7 (71.4%). Median age at diagnosis was 47 years, and median follow-up duration was 60 months (IQR 29–75). Mean calcium level at diagnosis was 12.7 mg/dL (range, 11.3–13.9), and mean parathormone level was 1115 ng/L (IQR 287–1470). Two patients (28.5%) had a palpable neck mass. Coexisting brown tumor was present in three patients (42.8%), and nephrolithiasis was found in one patient (14.2). Average tumor size was 29 mm (IQR 28–40). Capsular and vascular invasion were detected in six patients (85.7%), intrathyroidal spread was observed in two patients (28.5%), and soft tissue invasion was seen in three patients (42.8%). Parathyroid adenoma was present in one patient and parathyroid gland hyperplasia in another patient. Adjuvant radiotherapy was given to four patients (57.1%). There was no metastatic disease or death. At the last visit, two patients had increased parathormone levels and no additional focus could be detected in either. Patients with markedly elevated parathormone and calcium levels and a palpable larger mass on the neck should be evaluated for parathyroid cancer. En bloc resection is the mainstay treatment. Despite contradictory results, adjuvant radiotherapy to the neck may help to reduce the risk of local recurrence in patients with microscopic residual parathyroid carcinoma.

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  1. Ozolins A, Narbuts Z, Vanags A, Simtniece Z, Visnevska Z, Akca A et al (2016) Evaluation of malignant parathyroid tumours in two European cohorts of patients with sporadic primary hyperparathyroidism. Langenbeck's Arch Surg 401:943–951

    Article  Google Scholar 

  2. Obara T, Fujimoto Y (1991) Diagnosis and treatment of patients with parathyroid carcinoma: an update and review. World J Surg 15:738–744

    Article  CAS  Google Scholar 

  3. Koea JB, Shaw JH (1999) Parathyroid cancer: biology and management. Surg Oncol 8:155–165

    Article  CAS  Google Scholar 

  4. Hundahl SA, Fleming ID, Fremgen AM, Menck HR (1999) Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985–1995: a National Cancer Data Base Report. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 86:538–544

    Article  CAS  Google Scholar 

  5. Mohebati A, Shaha A, Shah J (2012) Parathyroid carcinoma: challenges in diagnosis and treatment. Hematol Oncol Clin North Am 26:1221–1238

    Article  Google Scholar 

  6. Wei CH, Harari A (2012) Parathyroid carcinoma: update and guidelines for management. Curr Treat Options in Oncol 13:11–23

    Article  Google Scholar 

  7. Givi B, Shah JP (2010) Parathyroid carcinoma. Clin Oncol (R Coll Radiol) 22:498–507

    Article  CAS  Google Scholar 

  8. Shane E (2001) Clinical review 122: parathyroid carcinoma. J Clin Endocrinol Metab 86:485–493

    Article  CAS  Google Scholar 

  9. Beus KS, Stack BC Jr (2004) Parathyroid carcinoma. Otolaryngol Clin N Am 37:845–854 x

    Article  Google Scholar 

  10. Shane E, Bilezikian JP (1982) Parathyroid carcinoma: a review of 62 patients. Endocr Rev 3:218–226

    Article  CAS  Google Scholar 

  11. Schantz A, Castleman B (1973) Parathyroid carcinoma. A study of 70 cases. Cancer 31:600–605

    Article  CAS  Google Scholar 

  12. Kebebew E (2001) Parathyroid carcinoma. Curr Treat Options in Oncol 2:347–354

    Article  CAS  Google Scholar 

  13. Busaidy NL, Jimenez C, Habra MA, Schultz PN, El-Naggar AK, Clayman GL et al (2004) Parathyroid carcinoma: a 22-year experience. Head Neck 26:716–726

    Article  Google Scholar 

  14. Bae JH, Choi HJ, Lee Y, Moon MK, Park YJ, Shin CS et al (2012) Preoperative predictive factors for parathyroid carcinoma in patients with primary hyperparathyroidism. J Korean Med Sci 27:890–895

    Article  CAS  Google Scholar 

  15. Fernandes JMP, Paiva C, Correia R, Polonia J, Moreira da Costa A (2018) Parathyroid carcinoma: from a case report to a review of the literature. Int J Surg Case Rep 42:214–217

    Article  Google Scholar 

  16. Clayman GL, Gonzalez HE, El-Naggar A, Vassilopoulou-Sellin R (2004) Parathyroid carcinoma: evaluation and interdisciplinary management. Cancer 100:900–905

    Article  Google Scholar 

  17. Fernandez-Ranvier GG, Khanafshar E, Jensen K, Zarnegar R, Lee J, Kebebew E et al (2007) Parathyroid carcinoma, atypical parathyroid adenoma, or parathyromatosis? Cancer 110:255–264

    Article  Google Scholar 

  18. Healy SJ, Soe KK (2016) Parathyroid cancer cases: a single center’s experience. AACE Clin Case Rep 2:e221–e2e7

    Article  Google Scholar 

  19. Akirov A, Asa SL, Larouche V, Mete O, Sawka AM, Jang R et al (2019) The clinicopathological spectrum of parathyroid carcinoma. Front Endocrinol (Lausanne) 10:731

    Article  Google Scholar 

  20. Kebebew E, Arici C, Duh QY, Clark OH (2001) Localization and reoperation results for persistent and recurrent parathyroid carcinoma. Arch Surg 136:878–885

    Article  CAS  Google Scholar 

  21. Dudney WC, Bodenner D, Stack BC Jr (2010) Parathyroid carcinoma. Otolaryngol Clin N Am 43:441–453 xi

    Article  Google Scholar 

  22. Boyle NH, Ogg CS, Hartley RB, Owen WJ (1999) Parathyroid carcinoma secondary to prolonged hyperplasia in chronic renal failure and in coeliac disease. Eur J Surg Oncol 25:100–103

    CAS  PubMed  Google Scholar 

  23. Anderson BJ, Samaan NA, Vassilopoulou-Sellin R, Ordonez NG, Hickey RC (1983) Parathyroid carcinoma: features and difficulties in diagnosis and management. Surgery 94:906–915

    CAS  PubMed  Google Scholar 

  24. Asare EA, Sturgeon C, Winchester DJ, Liu L, Palis B, Perrier ND et al (2015) Parathyroid carcinoma: an update on treatment outcomes and prognostic factors from the National Cancer Data Base (NCDB). Ann Surg Oncol 22:3990–3995

    Article  Google Scholar 

  25. Wynne AG, van Heerden J, Carney JA, Fitzpatrick LA (1992) Parathyroid carcinoma: clinical and pathologic features in 43 patients. Medicine (Baltimore) 71:197–205

    Article  CAS  Google Scholar 

  26. Munson ND, Foote RL, Northcutt RC, Tiegs RD, Fitzpatrick LA, Grant CS et al (2003) Parathyroid carcinoma: is there a role for adjuvant radiation therapy? Cancer 98:2378–2384

    Article  Google Scholar 

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This study did not receive any specific grants from any funding agencies in the public, commercial, or not-for-profit sector.

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Correspondence to Tugce Apaydın.

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Apaydın, T., Yavuz, D.G. Seven cases of parathyroid carcinoma and review of the literature. Hormones 20, 189–195 (2021).

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