[Diagnosis and treatment of parathyroid carcinoma: 9 cases report and literature review].
OBJECTIVE
To investigate the diagnosis and surgical treatment of parathyroid carcinoma.


METHODS
The clinical data of 9 cases of parathyroid carcinoma treated from January 1967 to December 2009 was analyzed retrospectively with the review of related Chinese literatures.


RESULTS
Parathyroid carcinoma accounted for 8.9% (8/90) of all patients with primary hyperparathyroidism in our hospital, and the other one case was transferred from another hospital. Of the patients, 8 cases were found with primary hyperparathyroidism. Primary surgery was carried out with small incision: 5 patients underwent en bloc resection, among which, 3 cases received central lymph node dissection; 2 patients received simple parathyroidectomy; one case underwent palliative tumor resection. The case from another hospital received subtotal thyroidectomy. Considering preoperative, intraoperative data and frozen sections pathology, all patients were diagnosed as parathyroid carcinoma. Nine patients were followed-up for 1 - 14 years, no recurrence occurred, and the patient received palliative resection died from carcinoma two years after the operation. In previous Chinese literatures and this group, there were total 146 patients reported as parathyroid carcinoma. Those patients were diagnosed through routine histopathology, accounted for 1.8% - 11.5% of patients with primary hyperparathyroidism.


CONCLUSIONS
The diagnosis of parathyroid carcinoma is established according to severe hypercalcemia, clinical features, subset B-ultrasound and Tc(99m)-sestamibi scanning, intraoperative finding of adherence to close structures and histopathology. The initial surgical procedure of choice is en bloc resection of the tumor by minimally invasive small incision, including adjacent structures and ipsilateral thyroidectomy. The prognosis is favorable after the operation.
Department of Surgery, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou 310009, China. 2xsurgery@gmail.com
Shao-ming
SM
Xu
Ping
P
Wang
Li-rong
LR
Chen
Zhi-yu
ZY
Li
Guo-gang
GG
Li
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000209:etiology; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D016105:Parathyroidectomy / Q000379:methods; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi
D017256:Technetium Tc 99m Sestamibi