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Parathyroid carcinoma: a case report
R Tkachenko1, L Zakhartseva2, A Golovko2
1State Scientific Institution "Scientific-Practical Centre of Preventive and Clinical Medicine", State Administration of Affairs, Kyiv, Ukraine.
Experimental Oncology
|April 2, 2019
Summary
Parathyroid carcinoma (PC), a rare cause of primary hyperparathyroidism (pHPT), requires early diagnosis. Immunohistochemistry is crucial for distinguishing PC from benign parathyroid adenomas, impacting patient prognosis.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Parathyroid carcinoma (PC) is a rare endocrine malignancy, often presenting as primary hyperparathyroidism (pHPT).
- Early recognition and surgical intervention are critical for improving patient prognosis and survival rates.
- PC typically presents with hypercalcemia and elevated parathyroid hormone (PTH) levels, though presentation can vary.
Observation:
- A 51-year-old female presented with persistent pHPT, anterior cervical hematoma, and dysphagia.
- Imaging revealed a heterogenic lesion on the posterior aspect of the left thyroid lobe.
- Preoperative laboratory tests showed only slightly elevated serum calcium levels.
Findings:
- Surgical exploration and parathyroidectomy were performed.
- Histopathological examination confirmed parathyroid carcinoma.
- Immunohistochemistry was essential for definitive diagnosis, differentiating PC from parathyroid adenoma.
- At 2-month follow-up, there were no signs of residual or recurrent disease.
Implications:
- This case highlights the importance of considering PC in the differential diagnosis of pHPT, even with subtle clinical and laboratory findings.
- Immunohistochemistry plays a vital role in the definitive diagnosis of PC when histological features are ambiguous.
- Timely diagnosis and appropriate surgical management are paramount for favorable outcomes in parathyroid carcinoma.
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