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Parathyroid Cancer

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Parathyroid Gland Disorders

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Abstract

Parathyroid carcinoma is a rare endocrine malignancy derived from the parenchymal cells of the parathyroid glands. It accounts for 1–5% of all cases of primary hyperparathyroidism and presents a clinical challenge in diagnosis, management, and adjuvant therapy. It should be suspected with markedly elevated serum calcium levels (>14 mg/dL or >3.5 mmol/L). Fine-needle aspiration cytology should be avoided if there is a suspicion of parathyroid carcinoma. This chapter discusses all topics related to parathyroid cancer including epidemiology, etiology and risk factors, pathogenesis, clinical presentation, diagnosis, staging, prognosis, treatment (surgical, medical, adjuvant, ablative, and future treatment), as well as surveillance and follow-up. Adequate surgical resection with en-bloc resection of all tumor and involved structures is the best initial treatment necessary for optimal outcomes, and is best performed by high-volume parathyroid surgeons. Few adjuvant therapies currently exist for the treatment of recurrent or metastatic disease. Patients with parathyroid carcinoma should have life-long surveillance. Management of refractory parathyroid carcinoma often focuses on optimizing treatment of hypercalcemia.

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Sakr, M.F. (2022). Parathyroid Cancer. In: Parathyroid Gland Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-07418-9_16

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