Large parathyroid tumors have an increased risk of atypia and carcinoma.
BACKGROUND
Risk for atypia and carcinoma in large parathyroid tumors is not known. Atypia and carcinoma were determined in small (<2 g) and large (≥2 g) tumors in patients undergoing parathyroidectomy for primary hyperparathyroidism.


METHODS
The study was a retrospective analysis of a 5-year prospective database. Tumor weight, histopathology, age, gender, calcium, and parathyroid hormone levels were registered. Patients with 4-gland disease were not included.


RESULTS
Among 353 parathyroid tumors, 313 weighed <2 g and 40 weighed ≥2 g. There was no difference in age between groups. Patients with large tumors were more frequently men and had higher calcium and parathyroid hormone levels. Atypia was found in 4 of 313 (1.3%) and 7 of 40 (17.5%) small and large tumors, respectively (P < .05). Corresponding figures for carcinoma were 1 of 313 (.3%) and 2 of 40 (5.0%) (P < .05).


CONCLUSIONS
Large parathyroid tumors have increased risk for atypia and carcinoma. Even so, most large parathyroid tumors are benign.
Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Patrick
P
O'Neal
Peter
P
Mowschenson
James
J
Connolly
Per-Olof
PO
Hasselgren
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002118:Calcium / Q000097:blood; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D049950:Hyperparathyroidism, Primary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D016105:Parathyroidectomy; D011446:Prospective Studies; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D010281:Parathyroid Hormone; D002118:Calcium