Functioning parathyroid carcinoma: Clinicopathologic features and rational treatment

Obara, Takao; Okamoto, Takahiro; Kanbe, Masako; Iihara, Masatoshi

doi:10.1002/(sici)1098-2388(199703/04)13:2<134::aid-ssu9>3.0.co;2-a

Cited by 81 publications

(60 citation statements)

References 40 publications

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“…They concluded that DNA cytometry may help differentiate patients whose PC is likely to be indolent (diploid tumours) from those with a tumour (aneuploid) more likely to be aggressive. Unfortunately, the aneuploid DNA pattern occurs in too large a fraction of benign parathyroid lesions to be useful for differentiating between PA and PC (Mallette 1992, Obara et al 1997. However, the DNA ploidy pattern may be a valuable prognostic factor to predict recurrence (Obara et al 1990(Obara et al , 1997.…”

Section: Discussionmentioning

confidence: 99%

Relationship of AgNOR counts and nuclear DNA content to survival in patients with parathyroid carcinoma

Lumachi¹,

Ermani²,

Marino³

et al. 2004

Endocr Relat Cancer

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The aim of this study was to evaluate the usefulness of DNA flow cytometry to determine tumor nuclear DNA index (DI), and nucleolar organizer region protein counts visualized by the argyrophil (AgNOR) technique, in confirming diagnosis and predicting clinical outcome of patients with parathyroid carcinoma (PC). We reviewed paraffin-embedded tissue sections, from 15 patients (median age 63 years, range 30-68 years) with PC who died of the disease, which were randomly compared with tissue sections from 15 age-and sex-matched patients with parathyroid adenoma (PA). The proliferative activity in parathyroid tumours as detected by DI and AgNOR counts was evaluated in all specimens. Both DI (1.37 AE 0.33 vs 1.0 AE 0.1) and AgNOR (3.01 AE 0.31 vs 1.54 AE 0.35) counts were higher ðP < 0:001Þ (Student's t-test) in patients with PC than in those with PA. Diploid (DI¼1), aneuploid (DI > 1) and hypoploid (DI < 1) neoplasms were found in 11 (PC ¼ 4, PA ¼ 7), 14 (PC ¼ 11, PA ¼ 3) and five (PC ¼ 0, PA ¼ 5) patients respectively. The average postoperative survival in patients with PC was 46.9 AE 37.4 months (range 21-146 months). The survivals of patients with aneuploid ðn ¼ 11Þ and diploid ðn ¼ 4Þ PC were 74.0 AE 58.1 and 34.1 AE 18.4 months (P=0.21) respectively. There was a significant relationship between DI and AgNOR counts (R=0.69, P < 0:01), but no correlation was found between survival and both DI (Rho ¼ 0.17, P ¼ 0:55) and AgNOR counts (Rho ¼ 0.26, P ¼ 0:35). Moreover, there was no correlation ðP ¼ NS) between the main preoperative biochemical parameters and survival. In conclusion, DI and AgNOR are useful in confirming the diagnosis of PC, but they are of little value in predicting the clinical outcome of patients with PC.

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Section: Discussionmentioning

confidence: 99%

Relationship of AgNOR counts and nuclear DNA content to survival in patients with parathyroid carcinoma

Lumachi¹,

Ermani²,

Marino³

et al. 2004

Endocr Relat Cancer

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“…Parathyroid cancer recurrences are observed 2-3 years on average after the operation in approx. 50-78% of patients (11,54).…”

Section: Treatment For Parathyroid Cancermentioning

confidence: 99%

“…It is recommended to remove the tumor en-bloc with thyroid lobe and isthmus on the lesion side (19,33). The important thing is that the capsule should be left intact in order to prevent scatter of the cancer cells (21,54). The operation includes removal of lymph nodes on the lesion side, together with neck muscles if affected by invasion (35,55).…”

Section: Treatment For Parathyroid Cancermentioning

confidence: 99%

“…They are observed most often 3-5 years after the first operation (54). Late results are improved by a possibility that resection of local recurrences can be repeated (11,35,55,57).…”

Section: Treatment For Parathyroid Cancermentioning

confidence: 99%

“…Operation is a treatment of choice both for primary tumor and for recurrences of the disease (11,21,54). Operative treatment has also a relieving effect on metabolic consequences of hypercalcemia, thus playing a role in extending patients' survival.…”

Section: Treatment For Parathyroid Cancermentioning

confidence: 99%

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