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A nationwide study on parathyroid carcinoma
Eeva M Ryhänen1, Helena Leijon2, Saara Metso3
1a The Division of Endocrinology , Abdominal Center, University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
Acta Oncologica (Stockholm, Sweden)
|April 1, 2017
Summary
Parathyroid carcinoma (PC) is a rare cancer with poor outcomes, but its incidence is increasing. Higher calcium and parathyroid hormone levels, along with distinct histopathological features, can help diagnose PC.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Parathyroid carcinoma (PC) is a rare endocrine malignancy.
- Diagnosis of PC is challenging, with historically poor patient outcomes.
- Recent data suggest a potential increase in PC incidence.
Purpose of the Study:
- To investigate the clinical and histopathological characteristics of parathyroid carcinoma (PC).
- To compare PC with atypical parathyroid (APA) and parathyroid adenomas (PA).
- To analyze the incidence trends of PC over time.
Main Methods:
- A nationwide study in Finland identified 32 PC cases between 2000-2011.
- Clinical and histopathological data were compared between PC, APA (n=28), and PA (n=72).
- Incidence rates were analyzed for 1955-1999 versus 2000-2013.
Main Results:
- PC cases exhibited significantly higher preoperative calcium and parathyroid hormone levels than APA and PA.
- Manifestations like hospitalization, renal, and bone involvement were more frequent in PC.
- Distinct histopathological features of PC included increased mitotic activity, diffuse growth, higher Ki67, and negative parafibromin. Incidence of PC increased significantly over the study period.
Conclusions:
- PC is associated with severe primary hyperparathyroidism, and calcium levels ≥1.77 mmol/l warrant suspicion.
- Distinct histopathological characteristics differentiate PC from PA.
- The incidence of parathyroid carcinoma has notably increased in recent decades.