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Primary hyperparathyroidism due to parathyroid cancer — a diagnostic and management challenge
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Abstract
Parathyroid carcinoma (PC) is a rare endocrine malignancy and the cause of primary hyperparathyroidism. It is usually associated with a high rate of local and distant recurrence. Laboratory findings and clinical symptoms may be similar to those in parathyroid adenoma. The histological features of PC may also be non-specific and the affected gland is often indistinguishable from a benign lesion. The proper diagnosis is commonly made months to years later when the disease recurs or metastases are present. Therefore, parathyroid carcinoma still remains a diagnostic and management challenge for many physicians. However, there are some features that, in combination, may help in diagnosis. Surgery still remains the only curative treatment, even in metastatic disease. In advanced, non-operable subjects, managing hypercalcaemia and controlling a tumour are the main goals. Morbidity is caused by hypercalcaemia rather than metastases. A multidisciplinary approach with experienced endocrinologists, pathologists, radiologists, nuclear medicine doctors, oncologists, and surgeons is needed to optimize patient outcome. (Endokrynol Pol 2015; 66 (2): 150–167)
Abstract
Parathyroid carcinoma (PC) is a rare endocrine malignancy and the cause of primary hyperparathyroidism. It is usually associated with a high rate of local and distant recurrence. Laboratory findings and clinical symptoms may be similar to those in parathyroid adenoma. The histological features of PC may also be non-specific and the affected gland is often indistinguishable from a benign lesion. The proper diagnosis is commonly made months to years later when the disease recurs or metastases are present. Therefore, parathyroid carcinoma still remains a diagnostic and management challenge for many physicians. However, there are some features that, in combination, may help in diagnosis. Surgery still remains the only curative treatment, even in metastatic disease. In advanced, non-operable subjects, managing hypercalcaemia and controlling a tumour are the main goals. Morbidity is caused by hypercalcaemia rather than metastases. A multidisciplinary approach with experienced endocrinologists, pathologists, radiologists, nuclear medicine doctors, oncologists, and surgeons is needed to optimize patient outcome. (Endokrynol Pol 2015; 66 (2): 150–167)
Keywords
parathyroid cancer; hypercalcaemia; primary hyperparathyroidism
About this articleTitle
Primary hyperparathyroidism due to parathyroid cancer — a diagnostic and management challenge
Journal
Issue
Article type
Review paper
Pages
150-167
Published online
2015-05-01
Page views
2198
Article views/downloads
4002
DOI
10.5603/EP.2015.0023
Pubmed
Bibliographic record
Endokrynol Pol 2015;66(2):150-167.
Keywords
parathyroid cancer
hypercalcaemia
primary hyperparathyroidism
Authors
Anna Dąbrowska
Jerzy Tarach
Agnieszka Zwolak
