Parathyroid cancer: A systematic review of diagnostic biomarkers

Davies, Matthew Philip; Evans, Thomas W.; Tahir, Fawzia; Balasubramanian, Sabapathy P

doi:10.1016/j.surge.2021.01.011

Cited by 10 publications

(8 citation statements)

References 144 publications

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“…Thus, calcium level cannot be the only evidence for the diagnosis of PC. Alkaline Phosphatase (ALP) levels were presented in 20 papers, four of which showed significantly higher in PC patients [ 15 ]. We also focus on the ALP of these PC patients included in our study.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Features and Treatment Strategy of Parathyroid Cancer: A Retrospective Analysis

Wang

Wen

Dai

et al. 2022

BioMed Research International

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Objective. To review the features and treatment of parathyroid cancer in our series. Explore the suitable extent of initial surgery and the effect of adjuvant radiotherapy in local recurrence. Methods. Seven cases of parathyroid cancer presented from 2014 to 2021. The presenting features, diagnosis, and treatment are presented. Results. Only two patients had multiple manifestations of hypercalcemia. Marked hypercalcemia, which was revealed to be an average of 13.9 mg/dl (range from 11.8 mg/dl to 15.8 mg/dl), was observed in four patients (57%). The others’ serum calcium levels were in the normal range with an average of 9.9 mg/dl (range from 8.6 mg/dl to 10.8 mg/dl). All seven patients had hyperparathyroidism with an average of 733 pg/ml (range from 113 pg/ml to 3193 pg/ml). En bloc resection was performed in two patients with neighboring structure invasion, and four patients with complete tumor capsules underwent tumor resection with limited resection of the thyroid gland. Postoperative adjuvant radiotherapy appeared unsuccessful for local recurrence. Conclusion. High calcium, high PTH, parathyroid occupation by ultrasound, and intraoperative invasion should be considered to have the possibility of parathyroid cancer. Open surgery is recommended and protecting tumor integration is the elementary surgery principle. The initial surgical extent should be decided by the invasion of the tumor. When PC has a local recurrence, the debulking surgery and adjuvant radiotherapy are always fake.

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Section: Discussionmentioning

confidence: 99%

The Clinical Features and Treatment Strategy of Parathyroid Cancer: A Retrospective Analysis

Wang

Wen

Dai

et al. 2022

BioMed Research International

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“…CDC73 mutations lead to loss of both function and immunohistochemical expression of parafibromin. Since the first discoveries, absence of parafibromin has been associated with diagnostic evidence [57][58][59] and worse prognosis of parathyroid carcinomas [59][60][61] and malignant behaviour of tumours histologically diagnosed as atypical adenomas [40]. However, controversies exist that can be attributed to technological differences and challenges [51], nuclear, nucleolar or cytoplasmic location of reactivity [62][63][64] or cases showing partial or weak expression [51,62,65,66].…”

Section: Parafibrominmentioning

confidence: 99%

“…Nevertheless, the information on APC in parathyroid tumours is quite scant. In a recent systematic review on biomarkers of parathyroid cancer [58], only five articles on APC levels (detected via immunohistochemistry or polymerase chain reaction) were included. In two publications, the APC expression in parathyroid carcinoma was found to be statistically significantly decreased.…”

Section: Apc Proteinmentioning

confidence: 99%

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Immunohistochemical Profile of Parathyroid Tumours: A Comprehensive Review

Uljanovs

Sinkarevs

Strumfs

et al. 2022

IJMS

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Immunohistochemistry remains an indispensable tool in diagnostic surgical pathology. In parathyroid tumours, it has four main applications: to detect (1) loss of parafibromin; (2) other manifestations of an aberrant immunophenotype hinting towards carcinoma; (3) histogenesis of a neck mass and (4) pathogenetic events, including features of tumour microenvironment and immune landscape. Parafibromin stain is mandatory to identify the new entity of parafibromin-deficient parathyroid neoplasm, defined in the WHO classification (2022). Loss of parafibromin indicates a greater probability of malignant course and should trigger the search for inherited or somatic CDC73 mutations. Aberrant immunophenotype is characterised by a set of markers that are lost (parafibromin), down-regulated (e.g., APC protein, p27 protein, calcium-sensing receptor) or up-regulated (e.g., proliferation activity by Ki-67 exceeding 5%) in parathyroid carcinoma compared to benign parathyroid disease. Aberrant immunophenotype is not the final proof of malignancy but should prompt the search for the definitive criteria for carcinoma. Histogenetic studies can be necessary for differential diagnosis between thyroid vs. parathyroid origin of cervical or intrathyroidal mass; detection of parathyroid hormone (PTH), chromogranin A, TTF-1, calcitonin or CD56 can be helpful. Finally, immunohistochemistry is useful in pathogenetic studies due to its ability to highlight both the presence and the tissue location of certain proteins. The main markers and challenges (technological variations, heterogeneity) are discussed here in the light of the current WHO classification (2022) of parathyroid tumours.

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“…Consequently, preoperative localization of parathyroid adenoma is very important to allow for minimally invasive surgery [ 1 ]. Preoperative diagnosis of parathyroid carcinoma is impossible in the vast majority of patients [ 7 ], although very high PTH and calcium levels, as well as palpable tumors and a large amount of tissue, may suggest parathyroid carcinoma. However, due to a lack of preoperative diagnostic modalities, the majority of parathyroid carcinomas are diagnosed postoperatively using pathologic examinations [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Giant Parathyroid Tumor: Parathyroid Adenoma versus Parathyroid Carcinoma

Gossili

Carlé

Andersen

2022

Case Reports in Endocrinology

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Parathyroid adenoma is the most common cause of primary hyperparathyroidism (PHPT). We present the preoperative detection of a giant parathyroid adenoma (GPA) using (99mTc)-sestamibi parathyroid scintigraphy in a patient presenting with severely elevated parathyroid hormone, hypercalcemia, hypophosphatemia, and vitamin D insufficiency. The patient complained of cerebral symptoms and intermittent abdominal discomfort without constipation. After surgical removal of the hyperactive parathyroid gland and D vitamin supplementation, all blood tests were normalized. The clinical and paraclinical characteristics of GPA may raise the suspicion of parathyroid carcinoma, but not absolutely in this case.

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Parathyroid cancer: A systematic review of diagnostic biomarkers

Cited by 10 publications

References 144 publications

The Clinical Features and Treatment Strategy of Parathyroid Cancer: A Retrospective Analysis

The Clinical Features and Treatment Strategy of Parathyroid Cancer: A Retrospective Analysis

Immunohistochemical Profile of Parathyroid Tumours: A Comprehensive Review

Giant Parathyroid Tumor: Parathyroid Adenoma versus Parathyroid Carcinoma

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