Parathyroid Carcinoma: An Up-to-Date Retrospective Multicentric Analysis

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Parathyroid carcinoma (PC) is a rare malignancy, accounting for approximately 1% of primary hyperparathyroidism (PHPT) cases.
• PC often presents with an indolent course, making it challenging to distinguish from benign PHPT without histological confirmation.
• The gold standard surgical treatment involves en bloc resection with homolateral thyroid lobectomy.

Purpose of the Study:

• To differentiate the key characteristics of PC from benign PHPT.
• To gather epidemiological data on PC within the Piedmont and Aosta Valley region.
• To analyze factors influencing PC recurrence and patient outcomes.

Main Methods:

• Retrospective analysis of PC cases from a regional cancer network (2007-present).
• Comparison of PC patient data with a cohort of benign PHPT patients.
• Evaluation of incidence, demographics, clinical presentation, biochemical markers, surgical techniques, and recurrence rates.

Main Results:

• PC incidence was found to be 0.05 cases per 100,000 inhabitants.
• PC affected males and females equally and occurred in younger patients compared to benign PHPT.
• PC patients exhibited significantly higher serum calcium and PTH levels, more frequent symptoms, and a 13-fold increased risk of relapse with non-radical resection.

Conclusions:

• Parathyroid carcinoma presents distinct epidemiological and clinical features compared to benign PHPT.
• En bloc resection is associated with a significantly lower risk of recurrence.
• Meticulous presurgical evaluation is essential for complete tumor extirpation and improved patient prognosis.