Surgical treatment of parathyroid carcinoma (Review)

Parathyroid Cancer - Occurrence, Diagnosis, Treatment

“…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). It is not difficult to take such decision as PC shows low aggressiveness and slow growth (14,50,58).…”

“…The most effective treatment for parathyroid cancer is radical en-bloc resection of the tumor during primary operation (8, 23) possibly followed by adjuvant teleradiotherapy on the tumor site (21,33,55). Such management gives a chance that the condition will be completely cured (8,31,32).…”

“…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). If only PC is suspected, all parathyroid glands should be inspected for assessment as it quite often happens that malignant tumor is accompanied by adenoma or proliferation (16,42).…”

“…Histopathological examinations performed during operative procedure rarely enable explicit assessment of malignancy or diagnosis of PC (12,18,34,44,55,(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85)(86). Histopathological diagnosis on postoperative material is also difficult, whereas "final" result is ambiguous and raises doubts among clinicians (12,44,51).…”

“…Operative treatment has also a relieving effect on metabolic consequences of hypercalcemia, thus playing a role in extending patients' survival. Pharmacotherapy is used for non-operable lesions or in unsuccessful surgical management to reduce the level of calcium in blood serum (12,55).…”