Parathyroid carcinoma in the Yorkshire and Humber region of the UK – a multi-centre study of presentation, management and outcomes

Purpose Our objective is to report on the management strategies and outcomes of patients with parathyroid cancer (PC) in the Yorkshire and Humber region of the UK. Pathology databases were interrogated for patients diagnosed with PC at three major centres in the region. Data was collected by two observers and all pathology reports were reviewed by a single consultant pathologist. The analyses were primarily descriptive and outcomes were compared with recently published literature. Methods All cases of PC diagnosed between 2006 and June 2019 were included. Data on presentation, treatment, histology and outcomes were recorded for each case. Results The series includes 27 patients, with a median age of 56 (range 46.5–72.5) years. No gender predisposition (M: F 13:14) was present. Twenty-two had the ipsilateral thyroid lobe (+/- lymph nodes) excised as part of definitive treatment. Nine of these had definitive surgery in two stages. Capsular, vascular and thyroid/soft tissue invasion were seen in 89%, 70% and 70% of patients respectively. One patient received adjuvant radiotherapy treatment. Recurrence was confirmed in one patient, causing mortality 70 months post diagnosis. Three other patients died of other causes during the study period, one of whom was suspected to have recurrent disease. Conclusions Rates of recurrence and mortality were low following surgical treatment for PC; however, diagnostic strategies and surgical practices were variable. The development of guidelines on the management of PC may reduce variability in treatment and improve patient outcomes.