Differentiating Atypical Parathyroid Neoplasm from Parathyroid Cancer

Christakis, Ioannis; Bussaidy, Naifa; Clarke, Callisia N.; Kwatampora, Lily; Warneke, Carla L.; Silva, Angelica; Williams, Michelle D.; Grubbs, Elizabeth G.; Lee, Jeffrey E.; Perrier, Nancy D.

doi:10.1245/s10434-016-5248-6

Cited by 45 publications

(37 citation statements)

References 33 publications

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“…The initial serum calcium and PTH levels observed in our patient are among the highest ever reported for PHPT due to benign adenoma [3,[8][9][10][13][14][15]. Although we were not surprised to see symptomatic improvement and resolution of hypercalcemia following hydration and bisphosphonate treatment, the 20-fold decrease in PTH level just prior to resection was unexpected.…”

Section: Discussionmentioning

confidence: 43%

“…Although parathyroid carcinoma accounts for only 0.005% of endocrine cancers and < 1% of PHPT [3], the diagnosis should always be considered in the setting of marked hypercalcemia. Suspicion should increase further upon detection of a palpable neck mass or parathyroid lesion exceeding 3 cm by imaging [2,3,8,9]. Comprehensive imaging to both characterize the lesion and to evaluate for metastatic disease is recommended [3], although invasion, lymph node involvement, and distant metastases are infrequently encountered on initial presentation [2,5].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, parathyroid carcinoma should be considered in such situations despite its low overall incidence [3,4]. Suspicion should increase further in the presence of a palpable neck mass or parathyroid lesion exceeding 3 cm by imaging [2,3,6,8,9]. Parathyroid carcinomas are differentiated from parathyroid adenomas by gross appearance [6,9] and microscopic criteria [7], however lesions with overlapping characteristics have been described, including atypical [8,9], cystic [11], and giant parathyroid adenomas [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Suspicion should increase further in the presence of a palpable neck mass or parathyroid lesion exceeding 3 cm by imaging [2,3,6,8,9]. Parathyroid carcinomas are differentiated from parathyroid adenomas by gross appearance [6,9] and microscopic criteria [7], however lesions with overlapping characteristics have been described, including atypical [8,9], cystic [11], and giant parathyroid adenomas [8][9][10]. Variable presentations including parathyroid crisis and spontaneous remission of previously diagnosed PHPT have been reported in association with such lesions [10,11,[14][15][16][17]19].…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Near-Remission of Hyperparathyroidism After Parathyroid Crisis

Lirov

Kairi

Gauger

2017

AACE Clinical Case Reports

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ObjectiveTo describe an unusual case of primary hyperparathyroidism due to a benign cystic parathyroid adenoma involving parathyroid crisis, profoundly elevated serum calcium and parathyroid hormone levels, and near-remission prior to surgery. MethodsWe describe the presentation, evaluation, and treatment of an elderly female with parathyroid crisis due to a benign cystic parathyroid adenoma. Issues related to management of parathyroid Abbreviations: PHPT = Primary Hyperparthyroidism; USN = Ultrasounds; PTH = Parathyroid Hormone; CT = Computed Tomography [Scan]. Intraoperative photos showing sequence of mobilization and resection in order of progression A-B. Left thyroid lobe (*), lesion ( †), trachea (Tr), esophagus (Es) Options Oncol. 2012;13:11-23. 4. James BC, Aschebrook-kilfoy B, Cipriani N, Kaplan EL, Angelos P, Grogan RH. The Incidence and Survival of Rare

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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spontaneous Near-Remission of Hyperparathyroidism After Parathyroid Crisis

Lirov

Kairi

Gauger

2017

AACE Clinical Case Reports

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“…The two entities have different clinical behaviors reflected in the overall recurrence rates, disease-free survival and overall survival. Atypical parathyroid adenomas present with a less severe biochemical profile and demonstrate an indolent clinical course compared with PCas [4]. …”

Section: Clinical Features Of Parathyroid Cancersmentioning

confidence: 99%

Epigenetic Alterations in Parathyroid Cancers

Verdelli

Corbetta

2017

IJMS

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Parathyroid cancers (PCas) are rare malignancies representing approximately 0.005% of all cancers. PCas are a rare cause of primary hyperparathyroidism, which is the third most common endocrine disease, mainly related to parathyroid benign tumors. About 90% of PCas are hormonally active hypersecreting parathormone (PTH); consequently patients present with complications of severe hypercalcemia. Pre-operative diagnosis is often difficult due to clinical features shared with benign parathyroid lesions. Surgery provides the current best chance of cure, though persistent or recurrent disease occurs in about 50% of patients with PCas. Somatic inactivating mutations of CDC73/HRPT2 gene, encoding parafibromin, are the most frequent genetic anomalies occurring in PCas. Recently, the aberrant DNA methylation signature and microRNA expression profile have been identified in PCas, providing evidence that parathyroid malignancies are distinct entities from parathyroid benign lesions, showing an epigenetic signature resembling some embryonic aspects. The present paper reviews data about epigenetic alterations in PCas, up to now limited to DNA methylation, chromatin regulators and microRNA profile.

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Surgical Aspects of Primary Hyperparathyroidism

Perrier

Lang

Farias

et al. 2020

Journal of Bone and Mineral Research

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Parathyroidectomy (PTX) is the treatment of choice for symptomatic primary hyperparathyroidism (PHPT). It is also the treatment of choice in asymptomatic PHPT with evidence for target organ involvement. This review updates surgical aspects of PHPT and proposes the following definitions based on international expert consensus: selective PTX (and reasons for conversion to an extended procedure), bilateral neck exploration for non‐localized or multigland disease, subtotal PTX, total PTX with immediate or delayed autotransplantation, and transcervical thymectomy and extended en bloc PTX for parathyroid carcinoma. The systematic literature reviews discussed covered (i) the use of intraoperative PTH (ioPTH) for localized single‐gland disease and (ii) the management of low BMD after PTX. Updates based on prospective observational studies are presented concerning PTX for multigland disease and hereditary PHPT syndromes, histopathology, intraoperative adjuncts, localization techniques, perioperative management, “reoperative” surgery and volume/outcome data. Postoperative complications are few and uncommon (<3%) in centers performing over 40 PTXs per year. This review is the first global consensus about surgery in PHPT and reflects the current practice in leading endocrine surgery units worldwide. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

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Differentiating Atypical Parathyroid Neoplasm from Parathyroid Cancer

Cited by 45 publications

References 33 publications

Spontaneous Near-Remission of Hyperparathyroidism After Parathyroid Crisis

Spontaneous Near-Remission of Hyperparathyroidism After Parathyroid Crisis

Epigenetic Alterations in Parathyroid Cancers

Surgical Aspects of Primary Hyperparathyroidism

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