title: Parathyroid carcinoma: a 16-year experience in a single institution.
abstract: BACKGROUND
  This study aims to describe our experiences of parathyroid carcinoma.
  
  
  METHODS
  The data of clinicopathological features, surgical treatment and outcomes of seven cases of parathyroid carcinoma among 171 patients who underwent surgery for primary hyperparathyroidism over a 16-year period were analyzed.
  
  
  RESULTS
  The major symptoms at the diagnosis included a neck mass in three cases and multiple bone pain in five. Two patients were asymptomatic. No remarkable increases of serum calcium levels were noted in the patients, but serum parathyroid hormone (PTH) concentrations were high in most of the patients (4 of 5 in available). A variety of imaging studies including ultrasonography, sestamibi scan, and computed tomography scan were helpful in identifying the abnormal parathyroid glands, but not specific for the diagnosis of parathyroid carcinoma. In most patients, the parathyroid carcinomas were suspected at the time of neck exploration, and confirmed by final histopathologic examinations. All patients underwent complete surgical excision with curative intent. During the follow-up period, one patient developed lung metastases 6 years later and the other one died of unrelated cause.
  
  
  CONCLUSIONS
  Preoperative diagnosis of parathyroid carcinoma is difficult, but operative findings are helpful in the diagnosis. The optimal surgical treatment is en block radical resection including adjacent structures when parathyroid carcinoma is suspected. Unusually, although our patients presented with high serum PTH concentrations, they had normal or mild elevated serum calcium concentrations. The reason of why should be investigated in future studies.
authors.affiliation: Thyroid Cancer Center, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Soon Won
authors.initials: SW
authors.lastname: Hong
authors.forename: Jong Ju
authors.initials: JJ
authors.lastname: Jeong
authors.forename: Kee-Hyun
authors.initials: KH
authors.lastname: Nam
authors.forename: Woong Youn
authors.initials: WY
authors.lastname: Chung
authors.forename: Hang-Seok
authors.initials: HS
authors.lastname: Chang
authors.forename: Cheong Soo
authors.initials: CS
authors.lastname: Park
mesh_terms: D000328:Adult; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016105:Parathyroidectomy; D017256:Technetium Tc 99m Sestamibi; D014057:Tomography, X-Ray Computed
chemical_list: D010281:Parathyroid Hormone; D017256:Technetium Tc 99m Sestamibi; D002118:Calcium