Primary Hyperparathyroidism Secondary to Simultaneous Bilateral Parathyroid Carcinoma

Brown, Jimmy J.; Mohamed, Hezla; Williams-Smith, Lorraine; Osborne, Ryan F.; Coker, Joan; Yee, Brian A.

doi:10.1177/014556130208100611

Cited by 14 publications

(6 citation statements)

References 8 publications

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“…These tumours are usually solitary and arise from a single gland; however, there have been reports of multi-glandular involvement [62]. Both right and left inferior glands have been counted as the most common location [3,8,63].…”

Section: Pathologymentioning

confidence: 99%

Parathyroid Carcinoma

2010

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Parathyroid carcinoma is a rare endocrine malignancy. The reported incidence is from 0.5 to 5% of primary hyperparathyroidism cases in various series. The cause is unknown, but clinical correlations with different genetic syndromes exist. Mutations in the HPRT2 gene seem to play a significant role in the pathogenesis of this disease. Men and women are equally affected, usually in the fourth or fifth decade of life. Most patients will present with signs and symptoms of hypercalcaemia. Cases of non-functioning carcinoma are exceedingly rare. Surgical resection is the most effective method of treatment and palliation. A significant proportion of patients will experience recurrence, and will need further surgical and, eventually, medical management of hypercalcaemia. The disease is progressive but slow growing. Most patients will require multiple operations to resect recurrent disease. The main cause of morbidity and mortality is the sequela of uncontrolled chronic hypercalcaemia rather than tumour burden. The current paper will review the epidemiology, pathogenesis, clinical presentation and diagnostic work-up of this disease. Surgical management in different scenarios is reviewed in detail, followed by other types of treatment and management of incurable disease.

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Section: Pathologymentioning

confidence: 99%

Parathyroid Carcinoma

2010

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“…Parathyroid carcinoma is usually a single‐gland tumour, but multiglandular involvement does occur27. Koea and Shaw7 observed a higher incidence of malignant transformation in the left inferior gland, whereas other series have described a right inferior gland preponderance28, 29.…”

Section: Pathologymentioning

confidence: 99%

Parathyroid carcinoma

Rawat

Khetan

Williams

et al. 2005

British Journal of Surgery

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“…There have been several reports of multi-glandular parathyroid carcinoma, and one in which bilateral parathyroid carcinoma was diagnosed in the setting of multi-glandular hyperplasia (20). However, in that case, the fourth gland exhibited normal histopathologic features.…”

Section: Discussionmentioning

confidence: 99%

Parathyroid carcinoma arising from four-gland hyperplasia

et al. 2011

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Objective-To report the use of immunohistochemical staining for parafibromin, APC and galectin-3 to evaluate the malignant potential of the resected parathyroid specimen in a patient initially presenting with primary hyperparathyroidism secondary to four-gland hyperplasia who subsequently developed metastatic parathyroid carcinoma.Methods-We describe a patient with primary hyperparathyroidism who underwent a 3 gland resection of hypercellular parathyroids with post-operative normalization of her serum calcium and parathyroid hormone levels. She returned four years later with recurrent hypercalcemia and underwent partial resection of her remaining hypercellular gland without improvement of her hypercalcemia. Selective venous sampling localized the source as draining into her azygous vein, and she was ultimately diagnosed with metastatic parathyroid carcinoma.Results-Immunohistochemical staining for parafibromin, APC and galectin-3 suggested the malignant potential of the atypical adenoma removed during the patient's original operation, which is believed to be the source of her metastatic disease. Access to this information by the treating surgeon may have prompted a more extensive en bloc resection or more vigilant follow-up that could have altered the patient's clinical course.Conclusion-Immunohistochemical staining for parafibromin, APC and galectin-3 can be used to help distinguish the source of metastatic disease in parathyroid carcinoma. Selective venous sampling may help localize metastatic parathyroid carcinoma when it is otherwise not apparent.

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Primary Hyperparathyroidism Secondary to Simultaneous Bilateral Parathyroid Carcinoma

Cited by 14 publications

References 8 publications

Parathyroid Carcinoma

Parathyroid Carcinoma

Parathyroid carcinoma

Parathyroid carcinoma arising from four-gland hyperplasia

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