Ultrasound features of malignancy in the preoperative diagnosis of parathyroid cancer: a retrospective analysis of parathyroid tumours larger than 15 mm

Abstract

In lesions >15 mm systematic ultrasound assessment of specific features provides a valuable tool to identify parathyroid cancers before surgery.

Variable sonographic spectrum of parathyroid adenoma with a novel ultrasound finding: dual concentric echo sign

“…In a recent study, Sidhu et al drew attention to the high positive predictive value of internal calcification in diagnosing parathyroid carcinoma [26]. Studying on adenomas of 15 mm or larger, they found calcified foci in 4 of 8 parathyroid carcinomas, while none of 61 benign lesions had any calcification.…”

Parathyroid Carcinoma

“…These included a high positive predictive value for local infiltration (100%) and calcification (100%), and a negative predictive value for the absence of suspicious vascularity (97.6%), a thick capsule (96.7%), and inhomogeneity (100%). 102 The authors suggest that in parathyroid lesions >15 mm in size, ultrasound assessment of specific features provides a tool that can identify a parathyroid carcinoma before surgery. The high predictive power of ultrasound is encouraging, but further validation in prospective studies is needed.…”

Preoperative Localization of Abnormal Parathyroid Glands

“…The US appearance of parathyroid carcinoma is similar to that of adenoma, although irregular shape and the invasion of adjacent structures suggest a malignant lesion. 25,26 The accuracy of US examination strongly depends on operator skill, as well as on the size and location of the parathyroid lesion. When experienced radiologists perform sonography in patients without prior neck surgery or concomitant thyroid diseases, the detection rate of parathyroid lesions is greater than 90%, while this rate declines significantly to less than 80% in case of a concomitant nodular goiter (see Figure 35.4).…”