Parathyroid cancer: An update |
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| Institution: | 1. Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain;2. Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA;3. Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Harvard Medical School Boston, MA, USA;4. Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA;5. Division of Surgical Oncology, Gustave Roussy Cancer Center and Paris-Sud University, Villejuif Cedex, Paris, France;6. Department of Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA;7. Instituto de Investigación Sanitaria del Principado de Asturias, CIBERONC, Oviedo, Spain;8. Division of Surgical Oncology, Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA;9. Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA;10. Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;11. Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA;12. Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA;13. University of Udine School of Medicine, Udine, Italy;14. Coordinator of the International Head and Neck Scientific Group, Padua, Italy;1. Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel;2. Department of Surgery, Rambam Health Care Campus, Haifa, Israel |
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| Abstract: | Parathyroid cancer (PC) is a rare malignant tumor which comprises 0.5–5% of patients with primary hyperparathyroidism (PHPT). Most of these cancers are sporadic, although it may also occur as a feature of various genetic syndromes including hyperparathyroidism-jaw tumor syndrome (HPT-JT) and multiple endocrine neoplasia (MEN) types 1 and 2A. Although PC is characterized by high levels of serum ionized calcium (Ca) and parathyroid hormone (PTH), the challenge to the clinician is to distinguish PC from the far more common entities of parathyroid adenoma (PA) or hyperplasia, as there are no specific clinical, biochemical, or radiological characteristic of PC. Complete surgical resection is the only known curative treatment for PC with the surgical approach during initial surgery strongly influencing the outcome. In order to avoid local recurrence, the lesion must be removed en-bloc with clear margins. PC has high recurrence rates of up to 50% but with favorable long-term survival rates (10-year overall survival of 60–70%) due to its slow-growing nature. Most patients die not from tumor burden directly but from uncontrolled severe hypercalcemia. In this article we have updated the information on PC by reviewing the literature over the past 10 years and summarizing the findings of the largest series published in this period. |
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| Keywords: | Hyperparathyroidism Hypercalcemia Parathyroid cancer Treatment Prognosis |
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