Typifying the atypical parathyroid adenoma

Bhargav, Panchangam Ramakanth

doi:10.4103/ijnm.ijnm_44_17

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“…The criteria for APA are nuclear atypia, less than four vascular invasions, less than half capsular invasion and mitosis. There are few case reports/series showing the existence of APA where nuclear medicine imaging had helped in revealing the distinctive imaging findings along with the metabolic complications . However, as there are no defined features of APA, the term was dropped by experts.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive parathyroid carcinoma—A missing entity between parathyroid adenoma and carcinoma: Scintigraphic and histological features

Singh

Vadi

Saikia

et al. 2019

Clinical Endocrinology

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Purpose: Minimally invasive parathyroid carcinoma (MIPC) is clinically and biochemically comparable with parathyroid adenoma (PA) though histopathologically differ from PA. MIPC is an intermediate of PA and parathyroid carcinoma (PC). In literature, there is no definite criterion to diagnose MIPC. Our aim was to evaluate and characterize the imaging and biochemical parameters with histological characteristics of MIPC.Methodology: Ten patients with MIPC were recruited from (single centre) Indian PHPT registry (www.india nphpt regis try.com) from January 2014 to July 2018. Clinical, biochemical, imaging and histological features of MIPC patients were reviewed. Results:The mean age of MIPC patients (n = 10; 3 males) was 39.9 ± 11.3 years (range: 17-50). All patients had an elevated preoperative parathyroid hormone (iPTH) level ranging from 427 to 2138 pg/mL (median: 1328). MIBI scan showed intensely avid and enlarged parathyroid tumours in all patients; LIPT in 6, RIPT in 3 and ectopic mediastinal in 1 with mean size of the tumours was 2.8 ± 1.1 cm. The mean of maximum standardized uptake value (SUVmax) of MIPC in F-18 fluorocholine PET/CT was 6.7 ± 1.1 (range 6.0-8.3). The mean tumour weight was 12 ± 9.5 g (range: 1.09-28). All MIPC patients had identified capsular invasion in 80% and vascular invasion in 50%only but there was no local invasion, lymph nodal or distant metastasis. The mean Ki-67 labelling index was 3.2 ± 2.7 (range 1.1-10). Conclusion:The study concluded that MIPC patients are less aggressive (on the basis of imaging and histopathological findings) and should be differentiated from parathyroid adenoma and carcinoma. K E Y W O R D Sminimally invasive parathyroid carcinoma, parathyroid adenoma, parathyroid carcinoma, primary hyperparathyroidism | 843 SINGH et al.

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Section: Introductionmentioning

confidence: 99%