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Open Access 01-11-2016 | ORIGINAL ARTICLE

Evaluation of malignant parathyroid tumours in two European cohorts of patients with sporadic primary hyperparathyroidism

Authors: Arturs Ozolins, Zenons Narbuts, Andrejs Vanags, Zane Simtniece, Zane Visnevska, Aycan Akca, Denis Wirowski, Janis Gardovskis, Ilze Strumfa, Peter E. Goretzki

Published in: Langenbeck's Archives of Surgery | Issue 7/2016

Abstract

Purpose

Parathyroid carcinoma (PC) is remarkable for its rare occurrence and challenging diagnostics. PC accounts for 0.1–5 % cases of primary hyperparathyroidism (PHPT). The differentiation from benign tumours is difficult even by morphological criteria. To address these issues, we assessed the PC frequency in two separate European PHPT cohorts and evaluated the demographic, clinical, morphological and molecular background.

Methods

A retrospective study was carried out, using continuously maintained database (2005–2014) of PHPT patients from two tertiary referral university hospitals in Europe. The demographic, clinical data and frequency of PC among surgically treated PHPT was detected. Immunohistochemistry (IHC) was performed to detect parafibromin, representing protein product of HRPT2 gene and proliferation marker Ki-67.

Results

Both PHPT cohorts were characterised by close mean age values (58.6 and 58.0 years) and female predominance. The frequency of PC differed significantly between the cohorts: 2.1 vs. 0.3 %; p = 0.004. PC was characterised by invariable complete loss of parafibromin contrasting with parathyroid adenomas. The proliferation fraction was similar in both PC cohorts (10.6 and 11.0 %). PC showed significantly higher proliferation fraction than typical parathyroid adenomas (1.6 %), atypical adenomas (1.6 %) or adenomas featuring focal loss of parafibromin (2.2 %).

Conclusions

PC frequency can range significantly between the two European cohorts. The differences can be attributable to selection bias of patients referred for surgery and are not caused by discordant definition of malignant parathyroid histology. Diffuse loss of parafibromin and increased proliferation fraction by Ki-67 are valuable adjuncts in PC diagnostics due to significant differences with various clinical and morphological subtypes of adenoma.

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Title: Evaluation of malignant parathyroid tumours in two European cohorts of patients with sporadic primary hyperparathyroidism
Authors: Arturs Ozolins
Zenons Narbuts
Andrejs Vanags
Zane Simtniece
Zane Visnevska
Aycan Akca
Denis Wirowski
Janis Gardovskis
Ilze Strumfa
Peter E. Goretzki
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 7/2016
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-015-1361-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of malignant parathyroid tumours in two European cohorts of patients with sporadic primary hyperparathyroidism

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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