Parathyroid carcinoma: a case report
DOI:
https://doi.org/10.32471/exp-oncology.2312-8852.vol-41-no-1.12775Keywords:
immunohistochemistry, parathyroid carcinoma, primary hyperparathyroidism, PTHAbstract
Summary. Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (pHPT). The tumor is mostly functioning with following high serum calcium and parathyroid hormone (PTH) levels. Consideration of PC in differential diagnosis of pHPT is important because the mortality and the prognosis depend on early recognition and surgical approach. A case of PC in 51-year old female patient with persistent pHPT is reported. A patient, referred with anterior cervical hematoma, dysphagia, underwent neck ultrasound, barium X-ray swallow test and neck computed tomography. On the posterior surface of left thyroid lobe, close to the esophagus the heterogenic lesion with irregular margins was found. The preoperative calcemia was slightly elevated. The patient underwent cervical exploration with parathyroidectomy. Histological exam showed parathyroid lesion with immunohistochemical confirmation of PC. After 2 months follow-up there are no signs of a residual-recurrent disease. Although laboratory tests revealed pHPT preoperatively, no clinical effects of elevated calcium and PTH concentration levels were presented. As histological features are not specific for the differential diagnosis between the parathyroid adenoma and PC, the immunohistochemistry remains the only useful tool for the definite diagnosis.
References
Marcocci C, Cetani F. Clinical practice. Primary hyperparathyroidism. N Engl J Med 2011; 365: 2389–97.
Forde R, Mitchell A, Duncan K, et al. Parathyroid carcinoma: a case report and review of the literature. West Indian Med J 2015; 64: 305–8.
Cetani F, Frustaci G, Torregrossa L, et al. A nonfunctioning parathyroid carcinoma misdiagnosed as a follicular thyroid nodule. World J Surg Oncol 2015; 13: 270.
Shane E. Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab 2001; 86: 485–93.
Agha RA, Fowler AJ, Saeta A, et al. The SCARE Statement: Consensus-based surgical case report guidelines. Int J Surg 2016; 34: 180–6.
Wilhelm SM, Wang TS, Ruan DT, et al. The American Association of Endocrine Surgeons Guidelines for definitive management of primary hyperparathyroidism. JAMA Surg 2016; 151: 959–68.
Bilezikian JP, Brandi ML, Eastell R. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab 2014; 99: 3561–9.
Fernandes JMP, Paiva C, Correia R. Parathyroid carcinoma: From a case report to a review of the literature. Int J Surg Case Rep 2018; 42: 214–7.
Solorzano CC, Carneiro-Pla D. Minimizing cost and maximizing success in the preoperative localization strategy for primary hyperparathyroidism. Surg Clin North Am 2014; 94: 587–605.
Lubitz CC, Hunter GJ, Hamberg LM, et al. Accuracy of 4-dimensional computed tomography in poorly localized patients with primary hyperparathyroidism. Surgery 2010; 148: 1129–37.
Silverberg SJ, Clarke BL, Peacock M. Current issues in the presentation of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab 2014; 99: 3580–94.
Whitson BA, Broadie TA. Preoperative ultrasound and nuclear medicine studies improve the accuracy in localization of adenoma in hyperparathyroidism. Surg Today 2008; 38: 222–6.
Sturniolo G, Gagliano E, Tonante A, et al. Parathyroid carcinoma: case report. G Chir 2013; 34: 170–2.
Cocorullo G, Scerrino G, Melfa G, et al. Non-functioning parathyroid cystic tumour: malignant or not? Report of a case. G Chir 2017; 38: 243–9.
DeLellis RA. Parathyroid tumors and related disorders. Mod Pathol 2011; 24: S78–93.
Rodriguez C, Nadéri S, Hans C, et al. Parathyroid carcinoma: A difficult histological diagnosis. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129: 157–9.
Udelsman R, Åkerström G, Biagini C, et al. The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab 2014; 99: 3595–606.
Christakis I, Silva AM, Kwatampora LJ, et al. Oncologic progress for the treatment of parathyroid carcinoma is needed. J Surg Oncol 2016; 114: 708–13.
Wang L, Han D, Chen W, et al. Non-functional parathyroid carcinoma: a case report and review of the literature. Cancer Biol Ther 2015; 16: 1569–76.
Schulte KM, Gill AJ, Barczynski M, et al. Classification of parathyroid cancer. Ann Surg Oncol 2012; 19: 2620–8.
Owen RP, Silver CE, Pellitteri PK, et al. Parathyroid carcinoma: a review. Head Neck 2011; 33: 429–36.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Experimental Oncology
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
