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Parathyroid carcinoma: a case series.

W K Cheah1, A Rauff, K O Lee

  • 1Department of Surgery, National University Hospital, Singapore. medcwk@nus.edu.sg

Annals of the Academy of Medicine, Singapore
|August 27, 2005
PubMed
Summary

Parathyroid carcinoma, a rare endocrine cancer, presents with severe hypercalcemia and neck masses. Surgical removal, including hemithyroidectomy, offers the best outcome for reducing recurrence.

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Area of Science:

  • Endocrinology
  • Oncology
  • Surgical Pathology

Background:

  • Parathyroid carcinoma is an exceptionally rare endocrine malignancy.
  • Primary hyperparathyroidism (PHPT) can be a presenting symptom or a recurrence after prior surgery.

Observation:

  • This case series reviews three patients diagnosed with parathyroid cancer.
  • Clinical presentations included osteitis fibrosa, renal stones, neck mass, and recurrent PHPT.
  • Patients exhibited severe hypercalcemia and significantly elevated parathyroid hormone levels.

Findings:

  • Histological examination confirmed parathyroid tumors with local invasion (capsular and vascular).
  • All patients underwent parathyroidectomy and ipsilateral hemithyroidectomy.
  • No lymph node metastasis was identified, and no recurrence was observed within a one-year follow-up.

Implications:

  • Suspicious clinical indicators for parathyroid carcinoma include marked hypercalcemia, palpable neck masses, and local recurrence.
  • Aggressive surgical management, including parathyroidectomy with ipsilateral hemithyroidectomy and nodal clearance, is crucial for minimizing local recurrence.
  • Early recognition and prompt surgical intervention are vital for improving patient outcomes in parathyroid cancer.

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