title: Controversies in the management of parathyroid carcinoma: A case series and review of the literature.
abstract: Parathyroid carcinoma is a rare malignancy representing less than 1% of primary hyperparathyroidism cases. Its management is controversial due to lack of large-scale, multicentric studies. We report 8 new cases of parathyroid carcinoma and review the literature. Preoperative diagnosis of carcinoma was possible in 2 (25%) cases. Unclear surgical margins were present in 5 (62.5%) patients; 4 of them underwent subsequent re-exploration and ipsilateral hemithyroidectomy, in one case associated to central lymph node dissection. Recurrent disease is reported in 2 (25%) patients. Considering the high incidence of local recurrence in case of unclear surgical margins, a re-exploration with ipsilateral hemithyroidectomy is indicated in these patients. A neck dissection should be performed only in case of clinically involved lymph nodes, avoiding prophylactic lymphectomy. An aggressive approach is indicated in case of local or distant recurrence to reduce hypercalcemia.
authors.affiliation: Department of Surgical Sciences, University of Cagliari, S. S. 554, Bivio Sestu, 09042 Monserrato, CA, Italy. Electronic address: fabiomedas@gmail.com.
authors.forename: Fabio
authors.initials: F
authors.lastname: Medas
authors.affiliation: Department of Surgical Sciences, University of Cagliari, S. S. 554, Bivio Sestu, 09042 Monserrato, CA, Italy. Electronic address: enricoerdas@medicina.unica.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: Erdas
authors.affiliation: Department of Surgical Sciences, University of Cagliari, S. S. 554, Bivio Sestu, 09042 Monserrato, CA, Italy. Electronic address: giulialoi@hotmail.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Loi
authors.affiliation: Department of Surgical Sciences, University of Cagliari, S. S. 554, Bivio Sestu, 09042 Monserrato, CA, Italy. Electronic address: frapodda@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Podda
authors.affiliation: Department of Surgical Sciences, University of Cagliari, S. S. 554, Bivio Sestu, 09042 Monserrato, CA, Italy. Electronic address: gpisano@unica.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pisano
authors.affiliation: Department of Surgical Sciences, University of Cagliari, S. S. 554, Bivio Sestu, 09042 Monserrato, CA, Italy. Electronic address: nicolosi@unica.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Nicolosi
authors.affiliation: Department of Surgical Sciences, University of Cagliari, S. S. 554, Bivio Sestu, 09042 Monserrato, CA, Italy. Electronic address: pgcalo@unica.it.
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Calò
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000517:prevention & control; D049950:Hyperparathyroidism, Primary / Q000209:etiology / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy
keywords: Parathyroid carcinoma; Parathyroid surgery; Primary hyperparathyroidism