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open access

Vol 73, No 1 (2022)
Original paper
Submitted: 2021-10-21
Accepted: 2021-11-15
Published online: 2022-02-08
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Parathyroid carcinoma — a study of 29 cases

Grzegorz Józef Kowalski1, Adam Bednarczyk1, Grzegorz Buła1, Agata Gawrychowska1, Jacek Gawrychowski1
DOI: 10.5603/EP.a2022.0003
·
Pubmed: 35156702
·
Endokrynol Pol 2022;73(1):56-63.
Affiliations
  1. Department of General and Endocrine Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

open access

Vol 73, No 1 (2022)
Original Paper
Submitted: 2021-10-21
Accepted: 2021-11-15
Published online: 2022-02-08

Abstract

Introduction: Parathyroid carcinoma is a rare condition and accounts for < 1% of cases of sporadic primary hyperparathyroidism. It accounts for 0.005% of all cancers. Often the differentiation between adenoma and carcinoma is challenging and requires multidisciplinary cooperation. Complete surgical resection is the treatment of choice. We present a retrospective analysis of 29 patients who were surgically treated for parathyroid cancer.

Material and methods: Between the years 1983 and 2018, 71 (7.0%) patients were treated for suspicion of parathyroid cancer among a group of 1019 operated for primary hyperparathyroidism.

Results: We confirmed the diagnosis of parathyroid cancer in 29 (2.8%) patients, 12 men and 17 women, aged 27 to 77 years, mean 55.1 years. That constituted 43.9% of the 71 patients with initial suspicion of cancer diagnosis. All operated patients were under long-term observation.

Conclusions: A diagnosis of parathyroid carcinoma should always be considered during surgery in patients diagnosed with primary hyperparathyroidism, especially in patients with severe hypercalcaemia, significantly enlarged neck circumference, and concomitant diseases of the renal and skeletal system. Parathyroid carcinoma is rarely definitively diagnosed preoperatively or even intraoperatively, and the final diagnosis can be made exclusively after operation. The optimal treatment is a complete surgical resection at a reference centre — specialized in parathyroid surgery — to improve outcomes and provide the best chance of recovery.

 

Abstract

Introduction: Parathyroid carcinoma is a rare condition and accounts for < 1% of cases of sporadic primary hyperparathyroidism. It accounts for 0.005% of all cancers. Often the differentiation between adenoma and carcinoma is challenging and requires multidisciplinary cooperation. Complete surgical resection is the treatment of choice. We present a retrospective analysis of 29 patients who were surgically treated for parathyroid cancer.

Material and methods: Between the years 1983 and 2018, 71 (7.0%) patients were treated for suspicion of parathyroid cancer among a group of 1019 operated for primary hyperparathyroidism.

Results: We confirmed the diagnosis of parathyroid cancer in 29 (2.8%) patients, 12 men and 17 women, aged 27 to 77 years, mean 55.1 years. That constituted 43.9% of the 71 patients with initial suspicion of cancer diagnosis. All operated patients were under long-term observation.

Conclusions: A diagnosis of parathyroid carcinoma should always be considered during surgery in patients diagnosed with primary hyperparathyroidism, especially in patients with severe hypercalcaemia, significantly enlarged neck circumference, and concomitant diseases of the renal and skeletal system. Parathyroid carcinoma is rarely definitively diagnosed preoperatively or even intraoperatively, and the final diagnosis can be made exclusively after operation. The optimal treatment is a complete surgical resection at a reference centre — specialized in parathyroid surgery — to improve outcomes and provide the best chance of recovery.

 

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Keywords

primary hyperparathyroidism; parathyroid adenoma; parathyroid hyperplasia; parathyroid carcinoma; parathyroidectomy

About this article
Title

Parathyroid carcinoma — a study of 29 cases

Journal

Endokrynologia Polska

Issue

Vol 73, No 1 (2022)

Article type

Original paper

Pages

56-63

Published online

2022-02-08

Page views

5536

Article views/downloads

626

DOI

10.5603/EP.a2022.0003

Pubmed

35156702

Bibliographic record

Endokrynol Pol 2022;73(1):56-63.

Keywords

primary hyperparathyroidism
parathyroid adenoma
parathyroid hyperplasia
parathyroid carcinoma
parathyroidectomy

Authors

Grzegorz Józef Kowalski
Adam Bednarczyk
Grzegorz Buła
Agata Gawrychowska
Jacek Gawrychowski

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