A case of parathyroid carcinoma mimicking parathyroid adenoma (original) (raw)

Parathyroid carcinoma: clinical presentation and treatment

International Congress Series, 2003

Carcinoma of the parathyroid gland is a rare cause of primary hyperparathyroidism, with incidence of less than 1%. Parathyroid carcinomas usually grow slowly, with a tendency for local invasion. The preoperative differential diagnosis between carcinoma and adenoma of parathyroid gland is often difficult because many of the signs and symptoms are similar. Patients with parathyroid carcinoma have a generally higher serum calcium level and PTH level, and incidence of renal and bone diseases, pancreatitis, peptic ulcer, and anemia. The most effective therapy for parathyroid cancer is complete resection of the tumor together with the ipsilateral thyroid lobe.

Parathyroid Carcinoma: The Importance of High Clinical Suspicion for a Correct Management

International Journal of Surgical Oncology, 2012

Background. Parathyroid carcinoma is an infrequent clinical entity whose diagnosis is very challenge. Indeed a pre-operative or intraoperative diagnosis of parathyroid carcinoma is reported in less than half cases described in the literature. Patients and Methods. A systematic review of pathological reports of our secondary referral hospital was done. From 2003 to 2011 one hundred and forty-four patients were operated for hyperparathyroidism. One patient with atypical adenoma and three patients with parathyroid carcinoma were included in this paper. Results. An en bloc resection of the tumor was performed in three patients. Two of this patients with diagnosis of parathyroid carcinoma are alive with no evidence of recurrence or metastasis, respectively, 48 and 60 months after the operation; one patient with diagnosis of atypical adenoma died for other disease 16 months after the operation. In the last patient a simple parathyroidectomy was performed. After that histology revealed the diagnosis of parathyroid carcinoma the patient underwent reoperation for left hemithyroidectomy and central compartment lymph node clearance. After 30 months a lung lobectomy was done due to metastasis. Conclusion. Parathyroid carcinoma should be considered in the differential diagnosis of PTH-dependent hypercalcemia because optional outcomes are associated with complete resection of the tumor at the time of initial operation.

Parathyroid Carcinoma: Sixteen New Cases and Suggestions for Correct Management

World Journal of Surgery, 1998

We undertook a retrospective study in 16 patients with parathyroid carcinoma, with the aim of conveying experience from management of this rare cause of hyperparathyroidism (HPT). From 1980 to 1996 we operated on 309 patients with HPT, 290 of whom had primary HPT, and parathyroid carcinoma was diagnosed in 16 (5.2%) cases. In none was the malignancy diagnosed preoperatively. The average serum calcium and parathyroid hormone levels were significantly higher (p < 0.05) than in patients with parathyroid adenoma, and the mean tumor size was 2.9 cm (median 2.5 cm, range 1.5-4.5 cm). Twenty-eight operations were performed with resulting normalization of serum calcium levels for more than 6 months in 11 patients. Six patients presented prolonged postoperative hypocalcemia (2-10 months), and five patients had persistent HPT. Ten patients experienced recurrent disease; the median disease-free period was 24 months (range 4 -72 months). None of the patients was treated with chemotherapy, one patient underwent radiation therapy (50 Gy in 25 sessions) but required reoperation for local recurrence 4 months later. Three patients are still alive (two with recurrence). Average survival was 40 months (median 31 months, range 11-131 months).

A Case Report on Parathyroid Carcinoma: A Diagnostic Dilemma

Bangladesh Journal of Nuclear Medicine, 2019

Parathyroid Carcinoma is a rare cause of primary hyperparathyroidism. Pre-operative diagnosis remains a challenge. Here we report a case referred to us for suspicious goiter with hypercalcemia. Cytological findings suggested it to a possible thyroid mass rather than parathyroid neoplasm. Serum parathormone level was high and the patient underwent surgery. Histopathology confirmed the diagnosis of parathyroid carcinoma. A diagnostic approach to parathyroid neoplasm, combining multimodality imaging and clinico-pathologic features, is discussed. Bangladesh J. Nuclear Med. 21(2): 122-124, July 2018

A Parathyroid Adenoma: Benign Disease Presenting with Hyperparathyroid Crisis

Case Reports in Medicine, 2010

Hyperparathyroid crisis is a rare manifestation of parathyroid disease. We present the case of a 53-year-old gentleman with a review of the current literature. He presented in acute renal failure with epigastric pain and vomiting. His serum-corrected calcium (CCa2+) was raised at 5.2 mmol/L, in addition to a massively raised parathyroid hormone (PTH) level (3957 ng/L). Ultrasound studies of the neck revealed a 2 cm well-defined mass inferoposterior to right thyroid lobe. CT scans of the neck showed a normal mediastinum and confirmed no associated lymphadenopathy. Having undergone medical resuscitation for 9 days, a neck exploration revealed a cystic mass, which was excised. Histological investigations revealed a 9.25 g, cystic parathyroid adenoma with no features of malignancy. His PTH and CCa2+returned to normal postoperatively. This suspicious presentation of benign disease, including a marked elevation in PTH, highlights the challenges facing the endocrine surgeon in dealing with...

Malignancy of parathyroid: An uncommon clinical entity

Indian Journal of Endocrinology and Metabolism, 2013

Parathyroid carcinoma is a very rare cause of hyperparathyroidism. The diagnosis is usually established on histopathological grounds of capsular and vascular invasion, but a potential clue to the diagnosis is also offered by the severity of clinical profile, abrupt onset of symptoms, and a high degree of hypercalcemia and raised serum parathyroid hormone (PTH). We report a case of an elderly female with a prolonged history of generalized weakness and bone pain along with bilateral renal calculi, classical bony lesions, and a high serum calcium and PTH level who underwent a right inferior parathyroidectomy considering a parathyroid adenoma as our diagnosis. However, the biopsy report was consistent with a parathyroid carcinoma, and so, she was further subjected to an ipsilateral hemithyroidectomy as a completion procedure. So, we would like to emphasize that its preferable to have a high index of suspicion for parathyroid carcinoma when these clues are present, than to miss the opportunity for surgical cure in the first go by failing to consider it in the differential diagnosis.

Parathyroid carcinoma: a review with three illustrative cases

Journal of Cancer, 2011

Parathyroid carcinoma is a rare disease, which accounts for less than 1% of all case of primary hyperparathyroidism and is usually not detected until the time of surgery or thereafter. For most patients preoperative staging is not available. A radical excision remains the standard management; the place of adjuvant radiotherapy is not well established yet. Local recurrence and/or the metastases are unfortunately frequent. The present paper presents an up to date review of the literature illustrated by three clinical cases.

Parathyroid carcinoma: diagnosis and management

European Journal of Surgical Oncology (EJSO), 2001

Parathyroid carcinoma is a rare and difficult diagnosis to make based on the histological features alone. We review five cases of parathyroid carcinoma in the past 30 years and the clinical and biochemical features that facilitate the making of the diagnosis. A favourable outcome can be expected with adequate surgical treatment.

Parathyroid carcinoma: review of a problematic case

Medical Journal of Indonesia, 2012

Karsinoma paratiroid merupakan neoplasma yang jarang ditemukan, dengan frekuensi kurang dari 1% dari seluruh kasus hiperparatiroidisme primer. Beberapa gambaran klinis dan biokimiawi dapat mengarahkan pada karsinoma paratiroid namun diagnosis pre dan intraoperatif yang akurat masih sulit ditegakkan. Studi ini melaporkan satu kasus karsinoma paratiroid yang terdiagnosis pasca-operasi. Intraoperatif ditemukan pembesaran kelenjar paratiroid yang telah menginfiltrasi laringeus rekuren dan kelenjar tiroid kanan. Hasil histopatologik menunjukkan nodul tumor yang dipisahkan oleh jaringan ikat tebal, disertai invasi pada kapsul dan jaringan sekitar. Diagnosis akhir karsinoma paratiroid ditegakkan berdasarkan gambaran klinis dan pemeriksaan spesimen.

THE PARATHYROID ADENOMAS CLINICAL AND THERAPEUTIC STUDY

The purpose of our study was the evaluation of epidemiological profile, the diagnosis, the therapeutic management and post-operative complications for patients suffering from parathyroid adenomas. This work is based on a retrspective study. Its purpose is to discuss the results found of 26 patients operated for parathyroid adenoma at the department of visceral surgery at the Ibn Rochd University hospital of Casablanca, during a period of 07 years, from January 2010 to December 2016, based on the data collected from the clinical files of the patients. The average age of our patients was 53 with a female predominance. The circumstances of discovery for disease were various: like the etiological assessment of a bone tumor and the fortuitous discovery at the time of a cervical surgery. The clinical signs of hypocalcemia were found among 61,54% of patients (asthenia, vomiting, polyuriapolydipsia syndrome, headache, and weight loss), while bone signs were found in 19,23% of patient and renal events were found in 7,69% of patient either. The value of blood-calcium among our patients was between 94 and 176mg /l with an average of 121,81 mg /l. All of our patients presented high levels of parathormone with an average to 115,06 pg/ml and extremes with 94 and 2897 pg/ml. The ultrasound revealed the parathyoid adenoma in 84,62% cases while i twas not decisive in 15,38% cases. On the other hand, the scintigraphy was decisive for all the patients having benefited from this examination. All our patients benefited from a parathyroidectomy of pathological gland. Extemporaneous examination revealed an appearance of parathyroid adenoma in 65.38% of cases, and parathyroid hyperplasia in 34.62% of cases. Nevertheless, conventional pathological examination revealed a parathyroid adenoma in all of our patients. Two of our patients developed a transitory hypocalcemia. The evolution was marked by a normalization of the bloos-calcium of all our patients.