Parathyroid Carcinoma and Ectopic Secretion of Parathyroid hormone

Cetani, Filomena; Pardi, Elena; Marcocci, Claudio

doi:10.1016/j.ecl.2021.07.001

Cited by 6 publications

(3 citation statements)

References 128 publications

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“… 3 – 5 The functional nature of 90% of PCs mean that most patients present with hypercalcemia as the initial manifestation of the disease. 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] The functional nature of 90% of PCs mean that most patients present with hypercalcemia as the initial manifestation of the disease. 6,7 The diagnosis and management of PC are complex because of its rarity and the lack of standard clinical management protocols. 8 Surgery remains the primary treatment option, with en bloc resection of the tumor and surrounding structures offering the best chance of a cure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term survival in a patient with metastatic parathyroid carcinoma harboring an EGFR sensitizing mutation: a case report

Ying,

Li,

Xia

et al. 2024

J Int Med Res

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Parathyroid carcinoma (PC) is a rare and aggressive endocrine malignancy with limited treatment options. Current treatments such as chemotherapy and radiotherapy have demonstrated limited efficacy. Here, we report the case of a male patient who presented with symptoms including polydipsia, polyuria, and joint pain. Further examination revealed a neck lump, hypercalcemia, and hyperparathyroidism, leading to a diagnosis of PC after en bloc surgery. Seven months later, the patient developed local recurrence and lung metastases, which were resected via left lateral neck dissection and thoracoscopic wedge resection. A 422-gene panel test revealed the presence of epidermal growth factor receptor ( EGFR) p.L858R (c. T2573G) mutation, which may sensitize the EGFR-tyrosine kinase inhibitor response, and phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha ( PIK3CA) p.E545KV (c. G1633A) mutation. After multidisciplinary treatment discussions, the patient was treated with the multi-target tyrosine kinase inhibitor, anlotinib, resulting in survival benefits for 19 months. This case highlights the potential of targeted therapy in terms of long-term survival in patients with distant metastatic PC, as well as the importance of precision therapy guided by genome sequencing to identify potential therapeutic targets.

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“… 3 – 5 The functional nature of 90% of PCs mean that most patients present with hypercalcemia as the initial manifestation of the disease. 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term survival in a patient with metastatic parathyroid carcinoma harboring an EGFR sensitizing mutation: a case report

Ying,

Li,

Xia

et al. 2024

J Int Med Res

View full text Add to dashboard Cite

show abstract

“…Parathyroid carcinoma (PC) is a clinically and genetically complex condition in want of better care [ 12 , 13 , 14 , 15 , 16 ]. Parathyroid carcinoma accounts for merely 0.05‰ of all cancers reported in the NCBD database [ 17 ], and 1–2% of all cases of primary hyperparathyroidism (pHPT) [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Mediastinal Parathyroid Cancer

Schulte

Galatà

Talat

2022

Cancers

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Parathyroid cancer (PC) is rare, but its pre-operative recognition is important to choose appropriate access strategies and achieve oncological clearance. This study characterizes features of mediastinal parathyroid cancer (MPC) and explores criteria aiding in the pre-operative recognition of malignancy. We assembled data from 502 patients with mediastinal parathyroid neoplasms (MPNs) from a systematic review of the literature 1968–2020 (n = 467) and our own patient cohort (n = 35). Thirty-two of the 502 MPNs (6.4%) exhibited malignancy. Only 23% of MPC patients underwent oncological surgery. Local persistence and early recurrence at a median delay of 24 months were frequent (45.8%), and associated with a 21.7-fold (95%CI 1.3–351.4; p = 0.03) higher risk of death due to disease. MPCs (n = 30) were significantly larger than cervical PC (n = 330), at 54 ± 36 mm vs. 35 ± 18 mm (χ2 = 20; p < 0.0001), and larger than mediastinal parathyroid adenomas (MPA; n = 226) at 22 ± 15 mm (χ2 = 33; p < 0.01). MPC occurred more commonly in males (60%; p < 0.01), with higher calcium (p < 0.01) and parathyroid hormone (PTH) levels (p < 0.01) than MPA. Mediastinal lesions larger than 3.0 cm and associated with a corrected calcium ≥ 3.0 mM are associated with a more than 100-fold higher odds ratio of being malignant (OR 109.2; 95%CI 1.1–346; p < 0.05). The composite 3 + 3 criterion recognized 74% of all MPC with an accuracy of 83%. Inversely, no MPN presenting with a calcium < 3.0 mM and size < 3.0 cm was malignant. When faced with pHPT in mediastinal location, consideration of the 3 + 3 rule may trigger an oncological team approach based on simple, available criteria.

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