One stage treatment of parathyroid cancer.
OBJECTIVE
To review the methods of treating parathyroid cancer in our series and report successful use of intraoperative frozen section to enable one stage surgical management.


METHODS
Seven cases of parathyroid cancer presented from 1991-2002. The presenting features, diagnosis and treatment are presented. They are separated into two groups based on method of referral and treatment.


RESULTS
Patients presented with symptoms of hypercalcaemia. Median corrected calcium was 3.49 mmol/l. Parathyroid hormone levels were raised in seven of eight cases, range 14.5-495 pmol/l. A high index of pre-operative suspicion and use of frozen section enabled a one step surgical procedure. Recurrence was impossible to treat successfully. Radiotherapy appeared successful for residual disease.


CONCLUSIONS
A high pre-operative index of suspicion for parathyroid carcinoma with use of frozen section at time of operation permits an optimal one step surgical procedure by en bloc resection followed by central lymph node excision. In cases where diagnosis has been made post-operatively radiotherapy may be beneficial.
Kirkby-Bott
J
J
Department of Surgery, Chelsea and Westminster Hospital, Fulham Rd, London SW10 9NH, UK.
Lewis
P
P
Harmer
C L
CL
Smellie
W J B
WJ
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
D010281:Parathyroid Hormone