Immunoperoxidase study of uncommon parathyroid tumors Report of two cases of nonfunctioning parathyroid carcinoma and one intrathyroid parathyroid tumor-producing amyloid

Ordóñez, Nelson G.; Ibañez, Michael L.; Samaan, Naguib A.; Hickey, Robert C.

doi:10.1097/00000478-198309000-00004

Cited by 45 publications

(16 citation statements)

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“…Findings of lymphocytic thyroiditis, similar to our case, and a microscopic focus of papillary thyroid carcinoma were detected in a case by Schmidt et al [9]. Ordoñez et al described a rare case of intrathyroidal parathyroid tumor producing amyloid, mimicking medullary carcinoma of the thyroid gland [14]. Nonfunctioning intrathyroidal parathyroid carcinomas have not been described.…”

Section: Discussionsupporting

confidence: 83%

Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

Duckworth

Winter

Vaysberg

et al. 2013

Case Reports in Pathology

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Intrathyroidal parathyroid carcinoma is an exceedingly rare cause of primary hyperparathyroidism. A 51-year-old African American female presented with goiter, hyperparathyroidism, and symptomatic hypercalcemia. Sestamibi scan revealed diffuse activity within an enlarged thyroid gland with uptake in the right thyroid lobe suggestive of hyperfunctioning parathyroid tissue. The patient underwent thyroidectomy and parathyroidectomy. At exploration, a 2.0 cm nodule in the usual location of the right inferior parathyroid was sent for intraoperative frozen consultation, which revealed only ectopic thyroid tissue. No parathyroid glands were identified grossly on the external aspect of the thyroid. Interestingly, postoperative parathyroid hormone levels normalized after removal of the thyroid gland. Examination of the thyroidectomy specimen revealed a 1.4 cm parathyroid nodule located within the parenchyma of the right superior thyroid, with capsular and vascular invasion and local infiltration into surrounding thyroid tissue. We present only the eighth reported case of intrathyroidal parathyroid carcinoma and review the literature.

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Section: Discussionsupporting

confidence: 83%

Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

Duckworth

Winter

Vaysberg

et al. 2013

Case Reports in Pathology

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“…The only curative treatment is en bloc resection (Flye and Brennan, 1981;Wynne et al, 1992). The few reports on nonproducing parathyroid carcinoma suggest a different disease with a more aggressive behavior (Table 1) (Aldinger et al, 1982;de Quervain, 1909;Guy, 1929;Hall and Chaf n, 1934;McQuillain, 1938;Mendiola, 1942;Merlano et al, 1985;Ordonez et al, 1983;Price and Mowat, 1932;Roffo and Landivar, 1914;Sieracki and Horn, 1960;Toland, 1931). The etiology of parathyroid carcinoma is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…After operation, only 3 of 13 patients with nonproducing parathyroid carcinoma received adjuvant therapy; 1 patient had no response to adriamycine; and 2 patients received radiotherapy postoperatively (Aldinger et al, 1982). Results of treatment of producing parathyroid carcinoma with vincristine and adriamycine were disappointing, but results of adjuvant radiotherapy were a cause for hope (Ordonez et al, 1983;Wynne et al, 1992). Therefore, based on 2 studies of treatment of neuro-endocrine carcinoma (Hainsworth et al, 1988;Moertel et al, 1991), we decided to treat our patient with a combination of radiotherapy and cisplatinum and etoposide.…”

Section: Discussionmentioning

confidence: 99%

Painful ophthalmoplegia from metastatic nonproducing parathyroid carcinoma: Case study and review of the literature

Eurelings¹,

Frijns²,

Jeurissen³

2002

Neuro-Oncol

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Parathyroid carcinoma is an uncommon malignancy. Of the fewer than 400 cases reported, most have been cases of producing parathyroid carcinoma with accompanying hypercalcemia. Only 13 patients with nonproducing parathyroid carcinoma have been described. Nine of these 13 patients had metastatic disease. We report a patient with i.c. metastasis. Distal metastases of producing parathyroid carcinoma are treated surgically to prolong survival and prevent complications of hyperparathyroidism and hypercalcemia. One half of the patients with producing parathyroid carcinoma die within 5 years, mostly because of the complications of hypercalcemia. Nonproducing parathyroid carcinoma compares unfavorably with producing parathyroid carcinoma in terms of tumor progression and prognosis. Few data on choice of therapy in nonproducing parathyroid carcinoma are available. We treated our patient with a combination of radiotherapy and chemotherapy. Treatment was followed by an unexpectedly prolonged survival of 31 months after diagnosis of metastatic disease. Neuro-Oncology 4, 44-48, 2002 (Posted to Neuro-Oncology [serial online], Doc. 01-023, October 3, 2001 W e report a patient who had nonproducing parathyroid carcinoma with painful ophthalmoplegia from i.c. metastasis. We treated this patient with cranial radiotherapy (5 3 400 cGy in 1 week) followed by 3 cycles of chemotherapy once every 3 weeks, with a combination of cisplatin (100 mg/m 2 on day 1) and etoposide (120 mg/m 2 on days 1, 2, and 3). In view of the extreme rarity of the tumor, clinical trials to test different treatment modalities are not feasible. Therefore, the development of future treatment strategies depends on anecdotal reports. Case StudyA 45-year-old woman was treated for Graves' disease at another hospital. After 1 year she developed problems swallowing and speaking. Because of suspected thyroid carcinoma, a hemithyroidectomy was performed. Pathological examination showed a nonproducing parathyroid carcinoma ( Fig. 1) (Schantz and Castleman, 1973;Vetto et al., 1993). Because the tumor was not radically removed, she received radiotherapy (4000 cGy at once followed by 6000 cGy in fractions in 4 weeks at the tumor site). One year later, she presented with headache, vomiting, double vision, and a painful left eye. At examination, ptosis and abduction paresis of the left eye were found. A cerebral MRI scan showed an enhancing lesion in and around the cavernous sinus ( Fig. 2A and 2B). The patient was treated with high-dose prednisolone, up to 80 mg per day, because of a tentative diagnosis of Tolosa Hunt syndrome (Yousem et al., 1990). Because the symptoms and signs did not subside, lymphoma or metastatic tumor were suspected. On admission, she had a complete bilateral ophthalmoplegia with ptosis and absent pupillary light re exes. Vision was unimpaired. Sensation was decreased bilaterally in the area of the rst branch of the trigeminal nerve. No abnormalities were found during routine laboratory tests, which included tests for thyroid stimulating hormone, T4...

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“…Grossly and histologically, nonfunctional PCs are usually similar in appearance to functional PCs [74]. The presence of PTH, and absence of thyroglobulin and calcitonin, by tumor immunohistochemistry may help confirm the diagnosis [75][76][77].…”

Section: Nonfunctional Pcmentioning

confidence: 98%

Parathyroid Cancer and the CDC73 Tumor Suppressor Gene

Simonds¹

2014

Int. J. Endo. Oncol.

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Parathyroid carcinoma (PC) is a rare endocrine neoplasm, usually causing severe primary hyperparathyroidism, that frequently causes death from unmanageable hypercalcemia. PC is frequently associated with somatic inactivating mutations of the CDC73 gene (previously called HRPT2), a gene discovered in association with the familial hyperparathyroidism-jaw tumor syndrome. DNA analysis for CDC73 mutation should be performed on all patients with seemingly sporadic PC since some 25% will carry a germline mutation. It is often difficult to make a firm diagnosis of PC by histopathology alone. That diagnosis often depends on the presence of local tissue invasion or distant metastases. If PC is suspected, en bloc resection at initial surgery is recommended. Medical therapy with cinacalcet, bisphosphonates or denosumab may temporarily ameliorate the hypercalcemia of inoperable PC.

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Immunoperoxidase study of uncommon parathyroid tumors Report of two cases of nonfunctioning parathyroid carcinoma and one intrathyroid parathyroid tumor-producing amyloid

Cited by 45 publications

References 0 publications

Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

Painful ophthalmoplegia from metastatic nonproducing parathyroid carcinoma: Case study and review of the literature

Parathyroid Cancer and the CDC73 Tumor Suppressor Gene

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