No abstract

The causes of primary hyperparathyroidism include parathyroid adenoma(PA), atypical parathyroid adenoma(AA) and parathyroid carcinoma(PC). This retrospective study aimed to find the clinicopathologic characteristics among these three diseases and unique characteristics of AA.Patients and Methods: One hundred patients who underwent parathyroidectomy due to primary hyperparathyroidism from January 1993 to December 2008 in Seoul National University Hospital were enrolled.The electronic medical records of 88 patients of PA, 10 patients of AA and 2 patients of PC were analyzed retrospectively.Results: Male to female ratio was same in AA group but female predominance was found in PA group and male predominance in PC group. The mean age of AA group was similar to PA group but PC group was younger than other groups (PA: 50.18 15.07yrs, AA: 49.1 13.76yrs, PC: 44.0 18.39yrs, p= 0.832). The patients with PC showed higher preoperative serum calcium (PA: 11.90 1.46mg/dl, AA: 11.96 1.48mg/dl, PC: 14.25 2.76mg/dl, p= 0.091), ionized calcium (PA: 1.57 0.21mg/dl, AA: 1.54 0.34mg/dl, PC: 2.27mg/dl, p= 0.008) than other two groups and PA and AA showed similar results. PC group showed high parathyroid hormone levels than those of AA and PA (PA: 335.30 465.40pg/ml, AA: 992.88 612.30pg/ml, PC: 1221.00 227.69pg/ml, p< 0.001). Clinical symptoms were found more in PC group and majority of other two groups were found asymptomatic. PC group measured heavier and larger than AA and PA.Conclusion: AA might be an intermediate stage between PA and PC. Close follow up might be needed after operation for AA.