Puesta al día: carcinoma paratiroideo

Abstract

An update on parathyroid carcinomaParathyroid carcinoma is a rare malignant disease that presents as a sporadic or familial primary hyperparathyroidism (PHP). The latter is associated with some genetic syndromes. It occurs with equal frequency in both sexes, unlike PHP caused by parathyroid adenoma that is more common in women. It should be suspected in cases of severe hypercalcemia, with high parathyroid hormone levels and a palpable cervical mass. Given the difficulty in distinguishing between parathyroid carcinoma and adenoma prior to the surgery, the diagnosis is often made after parathyroidectomy. The only curative treatment is complete surgical resection with oncologic block resection of the primary tumor to ensure free margins. Adjuvant therapies with chemotherapy or radiation therapy do not modify overall or disease-free survival. Recurrences are common and re-operation of resectable recurrent disease is recommended. The palliative treatment of symptomatic hypercalcemia is crucial in persistent or recurrent disease after surgery since morbidity and mortality are more associated with hypercalcemia than with tumor burden.

Recurrence hyperparathyroidism caused by synchronous parathyroid carcinoma and parathyromatosis in a patient with long-term hemodialysis

“…Parathyroid carcinoma is uncommon and occurs in 0.3-5% of all cases of primary hyperparathyroidism [ 13 , 15 , 16 ]. The etiology of this tumor is unknown.…”

“…Parathyroid carcinoma is a rare disease commonly caused by primary hyperparathyroidism and very rarely caused by long-term chronic stimulation due to SHPT [ 13 , 14 ]. Parathyromatosis is also rare, mainly because of spillage and seeding of the parathyroid tissue during parathyroid surgery [ 7 , 11 , 12 ].…”