Multiglandular Parathyroid Carcinoma: A Case Report and Brief Review

Abstract

A 53-year-old man with no past medical history was admitted with complaints of hematuria, flank and abdominal pain of one week duration. He also complained of an enlarging new neck mass one month before presentation. The laboratory assessment showed a calcium level of 17.3 mg/dL (normal 8.5-10.5 mg/dL), serum albumin 2.9 g/dL (normal 3.0-5.0 g/dL), serum creatinine 3.4 mg/dL (normal 0.5-1.2 mg/dL). A neck ultrasound showed a complicated left neck mass. He was hydrated for one week with improvement in his labs, showing a decrease in serum calcium to 9.3 mg/dL and a serum creatinine of1.8 mg/dL. He underwent a total thyroidectomy and parathyroidectomy. The pathology showed multiglandular parathyroid carcinoma. It is important for the physician and surgeon dealing with primary hyperparathyroidism to look for parathyroid carcinoma. A better knowledge and understanding of this condition would aid in early diagnosis and possibly increase the survival rate.

Current concepts in parathyroid carcinoma: a single Centre experience

“…After PC resection intra-operative PTH levels can fall significantly, although often not as quickly as with benign disease; no PTH may indicate incomplete tumour resection, or concomitant multiple gland hyperplasia [117], or even multiple PCs [118]. Exploration of all four parathyroids may be required as both carcinoma in multiple glands and the concurrent presence of PC and PA has been documented in the literature [119, 120]. Use of intraoperative PTH assay is subject to surgery scheduled for PT disease, and in case of PT incidentaloma the necessary kit for PTH reading may not be available.…”

Parathyroid Cancer: A Review

“…A complete and thorough exploration of all four glands will help identify the presence of concurrent adenomas and carcinomas. While rare, multiglandular carcinomas have been described in the literature [54];…”

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

“…isiknowledge.com/). This identified a total of 2 further studies, giving a total of 15 studies [15,16,[18][19][20][21][22][23][24][25][26][27][28][29][30].…”