[Hormone active versus hormone inactive parathyroid gland cancer]

Problems regarding diagnosis and treatment of hormonally active and hormonally inactive parathyroid carcinomas arise from opposite sides, as is shown in two resp. cases. In functionally active tumors parathyroid origin is clear--but how to prove malignancy in early tumor stages? In inactive tumors malignancy is sound--but how to prove their parathyroid origin? Meticulous histologic examination (semithin-Layer) and cytophotometric DNA-measurement may be helpful diagnostic tools for active tumors, immunohistochemistry and analysis of parathormone fragments in plasma and tumor-cell-culture for inactive tumors. Nevertheless the surgeon's decision for radical surgery sometimes will have to be put on the intraoperative macroscopic situs--in order to provide curative treatment.