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Up‐to‐date on parathyroid carcinoma: Analysis of an experience of 19 cases
Author(s) -
Iacobone Maurizio,
Lumachi Franco,
Favia Gennaro
Publication year - 2004
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20152
Subject(s) - medicine , parathyroid carcinoma , primary hyperparathyroidism , malignancy , surgery , hyperparathyroidism , carcinoma , retrospective cohort study
Background and Objectives Parathyroid carcinoma (PC) is a rare disease; experience with its management is limited. The aim of this retrospective study was to evaluate a relatively large series of patients suffering from PC. Methods Since 1980, PC was diagnosed in the 4.7% of cases of primary hyperparathyroidism (HPT) (19 patients). Clinical and biochemical features, and surgical outcome were analyzed. Results In patients with PC, the mean serum calcium was 3.34 mmol/L; the tumor size 30.5 mm. Malignancy was never diagnosed preoperatively. Thirty‐two operations were performed; six patients underwent repeated surgery. Recurrence of HPT was observed in 100% of patients. The median disease‐free interval was 15 months (range 2–74 months). Fifteen patients died because of the disease; median survival was 29 months (range 20–146 months). A significant correlation was found between late recurrences and prolonged survival; less advanced age and higher preoperative calcium levels predicted early recurrences. Conclusions Preoperative diagnosis of PC is difficult. Preoperative severe hypercalcemia should alert the surgeon. En bloc resection of the PC and the adjacent structures is the treatment of choice. Unfortunately, recurrences are common and long‐term survival rate is low. J. Surg. Oncol. 2004;88:223–228. © 2004 Wiley‐Liss, Inc.