Parathyroid Carcinoma: Sixteen New Cases and Suggestions for Correct Management

Favia, Gennaro; Lumachi, Franco; Polistina, F.; D’Amico, Davide

doi:10.1007/s002689900549

Cited by 128 publications

(89 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, the frequency of the disease is more common in Japan than in Western countries, accounting for approximately 5% of patients with pHPT [5]. Moreover, 5.2% of patients operated for pHPT were found to have parathyroid carcinoma in an Italian study [47]. In the present study, the higher frequency of parathyroid carcinoma compared to that in previous reports [3][4][5] might be attributed to racial differences.…”

Section: Discussioncontrasting

confidence: 55%

Trial to Predict Malignancy of Affected Parathyroid Glands in Primary Hyperparathyroidism

et al. 2003

View full text Add to dashboard Cite

Abstract. Parathyroid cancer is rare but relatively frequent in Japan compared to Western countries. Surgical parathyroidectomy is the primary choice for radical treatment of primary hyperparathyroidism (pHPT), hence it is important to distinguish malignant from benign tumor in the determination of surgical indication as well as method of operation. However, it is not easy to diagnose parathyroid cancer prior to operation. In the present study, we analyzed the background data, biochemical data and bone mineral density (BMD) of 131 patients with pHPT (111 benign and 20 malignant). BMD of the lumbar spine and mid-radius was measured by dual-energy X-ray absorptiometry. Serum levels of calcium, alkaline phosphatase (ALP), and parathyroid hormone (PTH) were significantly higher in malignant group compared to benign one. The extent of elevation of mid PTH seemed to be higher than that of intact PTH in malignant group. Age-, gender-, and race-adjusted BMD of distal one-third of radius was significantly decreased in malignant group compared to benign one, although that of lumbar spine was not significantly different between the two groups, indicating that osteopenia was marked in the region which was rich in cortical bone in malignant group. On the other hand, serum levels of calcium, ALP, and mid PTH as well as age were selected as predictors of malignancy in univariate logistic regression analysis, while serum level of intact PTH was not selected. In conclusion, radial BMD was lower in malignant group compared to benign one in pHPT. Serum levels of calcium, ALP and mid PTH were useful to predict malignancy of affected parathyroid glands in pHPT patients.

show abstract

Section: Discussioncontrasting

confidence: 55%

Trial to Predict Malignancy of Affected Parathyroid Glands in Primary Hyperparathyroidism

et al. 2003

View full text Add to dashboard Cite

show abstract

“…However, in 85±90% of the patients pHPT is attributed to a single PT adenoma, even if a great variation exists in the reported incidence of multiglandular disease (42). PT carcinoma is a rare tumor that in our experience was easy to detect preoperatively because of its relatively large size, usually ranging between 1.5 and 4.5 cm (43).…”

Section: Discussionmentioning

confidence: 99%

Advantages of combined technetium-99m-sestamibi scintigraphy and high-resolution ultrasonography in parathyroid localization: comparative study in 91 patients with primary hyperparathyroidism

Lumachi

Zucchetta

Marzola

et al. 2000

European Journal of Endocrinology

145

View full text Add to dashboard Cite

Objective: To evaluate the usefulness of the combination of 99m Tc-sestamibi/ 99m Tc-pertechnetate subtraction scintigraphy (SS) and high-resolution neck ultrasonography (US) in patients with primary hyperparathyroidism (pHPT) undergoing parathyroidectomy. Design and Methods: Ninety-one patients with proved pHPT were studied, excluding patients with persistent or recurrent disease. There were 65 (71.4%) women and 26 (28.6%) men, with a median age of 59 years (range 18±78 years). All patients underwent both SS and US prior to surgery, and the results were compared with operative and histological findings. The intraoperative quick-parathyroid hormone assay was available for 52 (57.1%) patients. When multiglandular disease was found, both SS and US were considered truly positive only when at least two enlarged parathyroid (PT) glands had been localized. Results: Eighty-three (91.2%) solitary PT adenomas and three (3.3%) carcinomas were found. Moreover, two (2.2%) patients had a double adenoma and three (3.3%) patients had diffuse PT hyperplasia. The overall sensitivity of combined SS US was 94.5% (86.8% and 80.4% for SS and US respectively). There was a significant P , 0X05Y Student's t-test) difference in size between the PT glands correctly identified and undetected by SS, whereas the site of the removed PT tumors significantly P , 0X05Y Fisher exact test) influenced only the US sensitivity. Conclusions: When the preoperative localization of the PT glands is chosen, the combination of SS and US represents a reliable noninvasive localization technique and should be considered for use in each patient with pHPT undergoing surgery.

show abstract

“…PC causes 0.6-5.2% of all cases of primary hyperparathyroidism (August et al 1993, Favia et al 1998. The NCDB reported 286 cases of PC between 1985 and 1995 (0.005% of the total NCBD cases), and approximately 390 cases were reported in the English literature from 1930 to 2000 (Hundhal et al 1999, Shane 2001.…”

Section: Discussionmentioning

confidence: 99%

Relationship of AgNOR counts and nuclear DNA content to survival in patients with parathyroid carcinoma

Lumachi¹,

Ermani²,

Marino³

et al. 2004

Endocr Relat Cancer

View full text Add to dashboard Cite

The aim of this study was to evaluate the usefulness of DNA flow cytometry to determine tumor nuclear DNA index (DI), and nucleolar organizer region protein counts visualized by the argyrophil (AgNOR) technique, in confirming diagnosis and predicting clinical outcome of patients with parathyroid carcinoma (PC). We reviewed paraffin-embedded tissue sections, from 15 patients (median age 63 years, range 30-68 years) with PC who died of the disease, which were randomly compared with tissue sections from 15 age-and sex-matched patients with parathyroid adenoma (PA). The proliferative activity in parathyroid tumours as detected by DI and AgNOR counts was evaluated in all specimens. Both DI (1.37 AE 0.33 vs 1.0 AE 0.1) and AgNOR (3.01 AE 0.31 vs 1.54 AE 0.35) counts were higher ðP < 0:001Þ (Student's t-test) in patients with PC than in those with PA. Diploid (DI¼1), aneuploid (DI > 1) and hypoploid (DI < 1) neoplasms were found in 11 (PC ¼ 4, PA ¼ 7), 14 (PC ¼ 11, PA ¼ 3) and five (PC ¼ 0, PA ¼ 5) patients respectively. The average postoperative survival in patients with PC was 46.9 AE 37.4 months (range 21-146 months). The survivals of patients with aneuploid ðn ¼ 11Þ and diploid ðn ¼ 4Þ PC were 74.0 AE 58.1 and 34.1 AE 18.4 months (P=0.21) respectively. There was a significant relationship between DI and AgNOR counts (R=0.69, P < 0:01), but no correlation was found between survival and both DI (Rho ¼ 0.17, P ¼ 0:55) and AgNOR counts (Rho ¼ 0.26, P ¼ 0:35). Moreover, there was no correlation ðP ¼ NS) between the main preoperative biochemical parameters and survival. In conclusion, DI and AgNOR are useful in confirming the diagnosis of PC, but they are of little value in predicting the clinical outcome of patients with PC.

show abstract

Parathyroid Carcinoma: Sixteen New Cases and Suggestions for Correct Management

Cited by 128 publications

References 22 publications

Trial to Predict Malignancy of Affected Parathyroid Glands in Primary Hyperparathyroidism

Trial to Predict Malignancy of Affected Parathyroid Glands in Primary Hyperparathyroidism

Advantages of combined technetium-99m-sestamibi scintigraphy and high-resolution ultrasonography in parathyroid localization: comparative study in 91 patients with primary hyperparathyroidism

Relationship of AgNOR counts and nuclear DNA content to survival in patients with parathyroid carcinoma

Contact Info

Product

Resources

About