Case series of diagnosis and surgery challenges in parathyroid carcinoma

Kartini, Diani; Kurnia, Ahmad; Yulian, Erwin Danil; Panigoro, Sonar Soni; Wibisana, I. Gusti Ngurah Gunawan; Wardana, Jessica

doi:10.1016/j.ijscr.2022.107390

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Imaging studies were crucial before surgical intervention .in our series neck US was fundamental in preoperative localization. Five of six patient with PC were diagnosed by neck US, which matches with other series [13,15,16] . All cases of recurrent HPT due to PC did sestamibi scan which were positive in all cases suggesting parathyroid tumor.…”

Section: Discussionsupporting

confidence: 85%

“…Fine needle aspiration cytology (FNAC) not done in our cases of parathyroid tumors as the sensitivity of FNAC in diagnosis of PC is very low and with possibility of seedling of cells with subsequent parathyromatosis and recurrence. Most of reports not recommended FNAC [13,15,16] .…”

Section: Discussionmentioning

confidence: 99%

“…While Diani K et al used frozen section in all neck procedures. And Intraoperative frozen section diagnosed two cases of six cases of PC [16] .…”

Section: Discussionmentioning

confidence: 99%

“…Diani K et al concluded that recurrences developed 3 years after the primary surgery, and the recurrence mainly occurred in the neck regional operative field, and the main presentation of recurrent case is recurrent hypercalcemia and recurrent HPT [16] . While in our study the recurrence of manifestation occurred from 7 months to 26 months from the initial surgery, in most of cases (5 cases) the reoperation weren't curative as after the 2 nd surgery the patients developed manifestation of hypercalcemia HPT mostly due to distant metastases , most of studies [18,19] concluded no statistical significant difference between radical en bloc resection and local excision of parathyroid tumor especially that there is no evidence confirmed malignancy before the initial surgery , while other reports suggested radical resection from the start when there is any suspicion of malignancy as severe hypercalcemia or 10 time above the normal serum parathormone to obtain adequate control and decrease the incidence of recurrence [20][21] Radiotherapy is indicated only in one case of our study as the tumor was very aggressive with gross infiltration of sternomastoid muscle and surrounding thyroid tissue and vessels but chemotherapy was not indicted in this study because PC is considered chemoresistant.…”

Section: Discussionmentioning

confidence: 99%

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Parathyroid Carcinoma and Recurrent Hyperparathyroidm: Challenges and Management Options

abdelrahman,

hassanein,

helmy

et al. 2024

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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Introduction: Parathyroid carcinoma is very rare, but it is resembling important cause of recurrent hyperparathyroidism. Till now no clear guidelines for treatment of parathyroid carcinoma and its associated conditions including hyperparathyroidism. The aim of the study to evaluate the incidence and management modalities of such challenging cases. Material and Methods: Retrospective study for 129 patients diagnosed as primary hyperparathyroidism From march 2012 to June 2020,. Recurrent hyperparathyroidism developed in 7 cases 6 patients of them due to parathyroid carcinoma .medical records and patients characteristics and pathological evaluation and treatment modalities were reviewed. Results: Parathyroid carcinoma diagnosed in 6 patients (4.6%):, 4 males and 2 females with a mean age of years (61.5) range 54-72 years. The mean serum calcium at the initial diagnosis of parathyroid carcinoma cases was 12.73 mg/ dL (10.8.-14.2 mg/dL). Elevated serum parathormone were noted in all patients preoperatively, with a mean of 1691.5 pg/ mL (630 -3366 pg/ mL). parathyroidectomy done in 5 patients and en block resection in one case in the initial operation, all cases developed recurrence of manifestation from (7 month-26 months) , reoperation needed for all cases and one case needed radiotherapy. Conclusion: Parathyroid carcinoma is very challenging disease with high rate of recurrence, multidisciplinary approach including surgery, medical treatment for hypercalcemia is needed to improve patients outcome .

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

“…While Diani K et al used frozen section in all neck procedures. And Intraoperative frozen section diagnosed two cases of six cases of PC [16] .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Parathyroid Carcinoma and Recurrent Hyperparathyroidm: Challenges and Management Options

abdelrahman,

hassanein,

helmy

et al. 2024

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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Pediatric parathyroid carcinoma and hyperparathyroidism-jaw tumor syndrome: A case report and literature review

Thompson,

Hubbard,

Ackah

et al. 2024

International Journal of Pediatric Otorhinolaryngology

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Metastatic parathyroid carcinoma diagnosed after five surgical attempts: a case report and review of the literature

Mahboobipour,

Pourabdollah,

Hadaegh

et al. 2024

J Cardiothorac Surg

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Background Diagnosis of parathyroid carcinoma as a rare cause of primary hyperparathyroidism is usually very challenging, even after surgical resection. Case presentation A 45-year-old woman with a diagnosis of primary hyperparathyroidism underwent surgery three years ago. Parathyroid adenoma resection and total thyroidectomy, due to incidental intraoperative finding of papillary thyroid carcinoma, were performed. She had been asymptomatic for 2.5 years before her PTH and calcium levels rose. The second surgery was performed based on parathyroid hyperplasia diagnosis, but the patient did not recover. She was then referred to us. Imaging modalities could not localize the PTH source. Sequential bilateral neck explorations were unsuccessful. As a last attempt, mediastinal exploration was performed. By confirming no parathyroid tissue in the mediastinum, excision of some tiny pulmonary nodules (previously considered as PTC metastasis) was done, which was confirmed to be parathyroid cancer metastasis. Conclusions Diagnosing parathyroid carcinoma is difficult because of unreliable diagnostic criteria. The correct diagnosis may be determined through the follow-up for recurrent hyperparathyroidism in a previously diagnosed case of parathyroid adenoma.

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Case series of diagnosis and surgery challenges in parathyroid carcinoma

Cited by 4 publications

References 17 publications

Parathyroid Carcinoma and Recurrent Hyperparathyroidm: Challenges and Management Options

Parathyroid Carcinoma and Recurrent Hyperparathyroidm: Challenges and Management Options

Pediatric parathyroid carcinoma and hyperparathyroidism-jaw tumor syndrome: A case report and literature review

Metastatic parathyroid carcinoma diagnosed after five surgical attempts: a case report and review of the literature

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