Characteristics of parathyroid carcinoma: A descriptive study using administrative data in Japan

Parathyroid carcinoma is a rare endocrine malignancy that is challenging to distinguish from nonmalignant primary hyperparathyroidism before surgery. This study compared the clinical characteristics, surgical practices, and outcomes between patients with parathyroid carcinoma and those with benign disease and evaluated the impacts of preoperative diagnosis and en bloc resection.

We conducted a descriptive analysis using data from a Japanese hospital-based administrative database. The study included patients undergoing initial parathyroid surgery between 2008 and 2023. We compared clinical characteristics, treatments, and postoperative outcomes between parathyroid carcinoma and nonmalignant primary hyperparathyroidism. In carcinoma cases, subgroup analyses were stratified whether of en bloc resection was performed.

Among 5728 patients, the parathyroid carcinoma and nonmalignant primary hyperparathyroidism groups included 175 and 4754 patients, respectively. A preoperative diagnosis was documented in 16% of carcinoma cases, and 38.9% underwent en bloc resection. Patients with a preoperative diagnosis were more often received en bloc resection.

The preoperative diagnosis of parathyroid carcinoma remains challenging. En bloc resection was performed more frequently when malignancy was suspected. These findings highlight the need for improved diagnostic strategies.