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ROLE OF EXTERNAL RADIOTHERAPY IN PARATHYROID CARCINOMA
Author(s) -
Nair A.,
Abraham D. T.,
Paul M. J.,
Seshadri M. S.,
Nihal T.,
Selvan C. K.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04118_18.x
Subject(s) - medicine , parathyroid carcinoma , primary hyperparathyroidism , radiation therapy , nodule (geology) , hyperparathyroidism , hypercalcaemia , carcinoma , metastasis , surgery , parathyroid neoplasm , radiology , cancer , parathyroid adenoma , calcium , paleontology , biology
Introduction Parathyroid carcinoma is a challenging problem to a surgeon and adjuvant radiotherapy is important to reduce the recurrence. Methods A retrospective review was conducted of all cases of parathyroid carcinoma from 1990–2006. 6 patients were identified. Results There was a male preponderance. Mean age of presentation was 49 years. The clinical presentation was similar to benign primary hyperparathyroidism except for the presence of palpable nodule in 80% of patients with carcinoma compared to 11% among patients with benign primary hyperparathyroidism. One patient had chronic pancreatits propably secondary to hyperparathyroidism. All patients had hypercalcaemia with elevated serum PTH levels and no significant difference compared to benign hyperparathyroidism. Surgery was done in all. Local metastasis to the cervical lymph nodes was seen in 33% off patients. The tumors showed a high predilection to the inferior parathyroid glands.. All subjects underwent radiotherapy with cobalt at mean dose of 50 cGy. The mean duration of recurrence was about 2 years. 50% had local recurrence, 2 had recurrent tumor excision including one from vocal cord. Bony metastasis was found in one as evidenced by hot spots in sestamibi scan. 2 of the 6 died, both of them had unrelated disease as cause of death. 1 lost to follow up. Conclusion Parathyroid carcinoma constitutes around 2–3% of patients. In the presence of a palpable nodule, chance of being malignant should be kept in mind. Recurrence rate can be reduced by post operative external radiotherapy.