A Rare Endocrine Malignancy: Retrospective Analysis of Parathyroid Cancer

Parathyroid carcinoma, a rare endocrine malignancy, is a significant diagnostic and therapeutic challenge due to its overlapping features with benign parathyroid diseases and high recurrence rates.

The study assessed the demographic, biochemical, surgical, and histopathological characteristics of parathyroid carcinoma patients at a high-volume endocrine surgery center and identified clinical predictors of postoperative outcomes.

A retrospective cohort study was conducted on 8 patients who underwent surgery for histopathologically confirmed PC between January 2018 and December 2023. Data on demographics, biochemical markers, imaging, operative approach, and postoperative outcomes were analyzed. Spearman's rank correlation and multivariate linear regression were applied to identify key predictors of postoperative parathyroid hormone levels.

The cohort comprised 4 females and 4 males with a mean age of 57.8 ± 7.1 years (range: 50-71 years). The mean preoperative serum PTH and calcium levels were: 688.96 ± 196.17 pg/mL and 12.90 ± 1.38 mg/dL, respectively. Distant metastasis was observed in 25% of cases, and lymph node involvement in 12.5%. Multivariate analysis revealed that male sex, preoperative calcium, intraoperative PTH, presence of comorbidities, and adjuvant therapies significantly influenced postoperative PTH levels (p < 0.05). Imaging was universally performed but lacked specificity for malignancy.

Parathyroid carcinoma presents a diagnostic challenge due to its similarity to benign disease. Preoperative evaluation, comprehensive histopathology, and en bloc surgical resection are crucial for curative treatment.