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BMC Endocrine Disorders
Published in: BMC Endocrine Disorders 1/2019

Open Access 01-05-2019 | Hyperparathyroidism | Research

Current concepts in parathyroid carcinoma: a single Centre experience

Authors: Valentina Ferraro, Lucia Ilaria Sgaramella, Giovanna Di Meo, Francesco Paolo Prete, Francesco Logoluso, Francesco Minerva, Marica Noviello, Giuseppina Renzulli, Angela Gurrado, Mario Testini

Published in: BMC Endocrine Disorders | Special Issue 1/2019

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Abstract

Background

Parathyroid carcinoma is a rare neoplasm that may present sporadically or in the context of a genetic syndrome. Diagnosis and management are challenging due to the lack of clinical and pathological features that may reliably distinguish malignant from benign disease.

Methods

From January 2013 to December 2017, from 358 consecutive patients affected by parathyroid diseases, 3 patients with parathyroid carcinoma were treated at our academic Department of General Surgery. We present our experience as illustrative of the different features of clinical presentation of parathyroid carcinoma and review its management considering the recent relevant literature.

Results

Case 1: A 62-year-old man was hospitalized for left-sided palpable neck mass, hypercalcemia and elevated PTH. US-guided FNA was suspect for parathyroid carcinoma. A large cystic mass was excised in bloc with total thyroidectomy and central neck dissection. Genetic studies framed a pathologically confirmed parathyroid carcinoma within MEN1 syndrome. Case 2: A 48-year-old woman with hypothyroidism had total thyroidectomy performed for a suspect for right follicular thyroid lesion. Pathology revealed parathyroid carcinoma. Case 3: A 47 year-old man was admitted for hypercalcaemic crisis and renal failure in the context of PHPT. A lesion suggestive on US and MIBI scan for parathyroid adenoma in the right lower position was removed by mini-invasive approach. Pathology revealed parathyroid cancer and patient had completion hemythyroidectomy and central neck dissection.

Conclusion

Parathyroid cancer is a particularly rare endocrine malignancy, however it should be suspected in patients with primary hyperparathyroidism when severe hypercalcemia is associated to cervical mass, renal and skeletal disease. Parathyroid surgery remains the mainstay of treatment. Radical tumour resection and expedited treatment in a dedicated endocrine Center represent crucial prognostic factors.
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Metadata
Title
Current concepts in parathyroid carcinoma: a single Centre experience
Authors
Valentina Ferraro
Lucia Ilaria Sgaramella
Giovanna Di Meo
Francesco Paolo Prete
Francesco Logoluso
Francesco Minerva
Marica Noviello
Giuseppina Renzulli
Angela Gurrado
Mario Testini
Publication date
01-05-2019
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue Special Issue 1/2019
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/s12902-019-0368-1

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