Focus on parathyroid carcinoma

Abstract

Parathyroid carcinoma is a malignant neoplasm affecting 05-2 per cent of all patients with primary hyperparathyroidism that was first described by de Quevain in 1904. To day it continues to defy diagnosis and treatment. It is difficult to diagnose in part because of its rarity, lack of definitive diagnostic markers and overlapping clinical features of benign primary hyperparathyroidism. As a result initial surgical treatment is inadequate essentially leading to disease recurrence where complete cure is unlikely. En bloc surgical resection remains the only curative treatment, and high priorities are improving diagnostic methods, and clinical staging for resection once the disease is suspected. Margin status at resection is related to prognosis. Thus, a trend towards aggressive surgical management has improved outcomes. The recurrence rate of parathyroid carcinoma is as high as 80% with survival rates <50% at 10 years. Results of chemotherapy are disappointing. However, recent trials using radiation therapy are promising, but require further study.

Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

“…ТАБ образования ОЩЖ следует избегать, во-пер-вых, по причине низкой информативности в качестве дифференциальной диагностики между доброкаче-ственным и злокачественным образованием, во-вторых, имеется высокий риск распространения опу-холевых клеток по ходу биопсийного тракта [116,117].…”

Expand+In Vivoiv.iiarjournals.orgIn Vivo September-October 2017 vol. 31 no. 5 925-930 Parathyroid Carcinoma in Patients that Have Undergone Surgery for Primary Hyperparathyroidism

“…The sensitivity of preoperative localization methods for reoperations of parathyroid carcinoma was set at 69% for sonography, 67% for CT, 93% for MRI and 79% for MIBI scintigraphy (15). The fine needle aspiration biopsy (FNAB) is not recommended, because when the parathyroid carcinoma is suspected preoperatively, the chance of positivity is low and the risk of tumor cells dissemination occurs (4,16). In our patients, we recommend the performance of SPECT-CT in combination with MRI.…”

Non-functional parathyroid carcinoma: a case report and review of the literature

“…48 In addition, FNA biopsy may not be used to distinguish benign from malignant parathyroid tumors of the primary lesion. 49 However, FNA biopsy maybe used to distinguish thyroid from parathyroid tissue or to identify metastatic parathyroid carcinoma. 50 Frozen section analysis is of little value and unreliable because the histopathological features of parathyroid carcinoma may overlap with those of parathyroid adenoma.…”