Parathyroid carcinoma: problems in diagnosis and the need for radical surgery even in recurrent disease

Methods and Results Parathyroid carcinoma was diagnosed clinically and histologically in four patients (0.4%). In two of these patients diagnosis of parathyroid cancer was delayed by misinterpretation of the histopathology leading to an autotransplantation of malignant parathyroid tissue in one case...

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Bibliographic Details
Published in:European journal of surgical oncology 2001-06, Vol.27 (4), p.383-389
Main Authors: Dotzenrath, C, Goretzki, P.E, Sarbia, M, Cupisti, K, Feldkamp, J, Röher, H.-D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Diagnosis, Differential
Endocrinopathies
Female
histopathology
Humans
Hyperparathyroidism - etiology
Immunohistochemistry
Magnetic Resonance Imaging
Male
Malignant tumors
Medical sciences
metastases
parathyroid carcinoma
Parathyroid Neoplasms - complications
Parathyroid Neoplasms - diagnosis
Parathyroid Neoplasms - diagnostic imaging
Parathyroid Neoplasms - pathology
Parathyroid Neoplasms - surgery
Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)
surgery
Surgical Procedures, Operative - methods
Tomography, Emission-Computed
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Methods and Results Parathyroid carcinoma was diagnosed clinically and histologically in four patients (0.4%). In two of these patients diagnosis of parathyroid cancer was delayed by misinterpretation of the histopathology leading to an autotransplantation of malignant parathyroid tissue in one case. In two patients multivisceral surgery was performed: beside thyroidectomy, neck dissection, tracheal wall resection and resection of the muscular layer of the oesophagus one patient received oesophagectomy and gastric transposition and one patient a lung wedge resection. Both patients had a temporary palliation of tumour-associated symptoms after multivisceral surgery. The first patient died 2 years after oesophagectomy and 12 years after primary diagnosis from local tumour recurrence and cachexia. The second patient is living with tumour recurrence presenting a serum calcium level of 4.2 mmol/l (normal range 2.0 to 2.5 mol/l) and multiple brown tumours 2 years after lung resection and 6 years after the primary diagnosis. Conclusions We conclude that parathyroid carcinomas, being difficult to diagnose, warrant radical surgery, including multivisceral resection to prolong survival and reduce tumour and hypercalcaemia associated symptoms.
ISSN:0748-7983
1532-2157
DOI:10.1053/ejso.2001.1122