Large Retrosternal Parathyroid Carcinoma with Primary Hyperparathyroidism

Abstract

Parathyroid carcinoma is an uncommon cause of parathyroid hormone (PTH)-dependent hypercalcaemia, accounting for less than 1% of all cases of hyperparathyroidism. Parathyroid carcinoma is an indolent tumour with rather low malignant potential. Consideration of parathyroid carcinoma in the differential diagnosis of hypercalcaemic disorders is important because the morbidity and mortality are substantial and the best prognosis is associated with early recognition and surgical resection. Clinical indicators favouring parathyroid carcinoma over benign disease include markedly raised serum calcium levels, PTH and alkaline phosphatase. A palpable neck mass with both kidney and skeletal manifestations also give a high index of suspicion of parathyroid carcinoma. Histopathology alone is not sufficient to diagnose parathyroid cancer; it has to be correlated with the clinical findings. The initial and most effective treatment for parathyroid carcinoma is complete resection of the primary lesion, and repeated operations for recurrence are useful. The prognosis of parathyroid carcinomas is quite variable; 5-year survival rates vary from 40% to 86%, while the 10-year survival rate is approximately 49%. We report a case of parathyroid carcinoma occurring in a 55-year-old woman who presented with bone pain and hypercalcaemia.

Ultrasound features of malignancy in the preoperative diagnosis of parathyroid cancer: a retrospective analysis of parathyroid tumours larger than 15 mm

“…Observed changes relate to characteristic features of the gland itself and its presentation in the context of surrounding tissue. Full exploration of ultrasound features may require use of high-resolution techniques, colour Doppler ultrasound and consultation of Not described Not described Not described Not described Not described 1/1 Not described Tan [21] 1 Not described Not described Not described Not described Not described 1/1 Not described Bernstein [25] 1 1/1 Not described 1/1 Not described Not described Not described Not described Daly [15] 2 2/2 Not described 2/2 Not described Not described Not described Not described Ceriani [26] 1 Not described Not described Not described Not described 1/1 Not described Not described Rufener [27] 1 1/1 Not described Not described Not described Not described Not described Not described Harris [22] 1 Not described Not described Not described Not described Not described 1/1 0/1 Pahlavan [23] 1 1/1 Not described Not described Not described Not described Not described 0/1 Ito [24] 1 Not described Not described Not described Not described Not described Not described Not described Marcy [28] 1 0/1 1/1 1/1 Not described Not described 1/1 Not described Edmonson [ …”

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Positron emission tomography/computed tomography imaging of brown tumors mimicking multiple skeletal metastases in patient with primary hyperparathyroidism

“…[1] Clinically, brown tumors most often manifest as slowly growing, painful masses. [2] Brown tumors occur more commonly in the fifth and sixth decades of life and they can be seen in monoostotic and polyostotic forms.…”

Brown tumors simulating metastases on FDG PET in a patient with parathyroid carcinoma

“…Histological biopsy of a lytic lesion in the os ilium revealed brown tumour, and parathyreoidectomy revealed a parathyroid carcinoma. Parathyroid carcinoma is a very rare cause of PTH-dependent hypercalcaemia, accounting for less than 1% of all cases of hyperparathyroidism [1]. In primary hyperparathyroidism, brown tumour, or osteitis fibrosa cystica, is an uncommon bone disease and usually occurs in patients in advanced stages of the disease [2][3][4].…”