Parathyroid carcinoma: A rare cause of hyperparathyroidism in a geriatric patient underwent orthopedic surgery

Abstract

Parathyroid cancer is a rarely encountered disease which may accompany with hyper-parathyroidism. It is hard to diagnose the disease before surgical treatment and to differentiate it completely from adenoma. The treatment of parathyroid cancer includes removal of the tumor and the thyroid lobe completely on the same side through neck exploration and removing the lymph nodes at the neighborhoods. For a successful operation, it is required to diagnose the disease preoperatively and to determine whether the disease spreads locally or extensively and to plan the surgical removal of the tumor on the basis of such findings. In this paper,  a 71-year-old patient with an incidental parathyroid carcinoma diagnosed in the early postoperative period foolowing anemergent orthopedic operation was presented. The final diagnosis was determined after the histopathologic examination of the parathyroid gland.

Keywords

• Parathyroid carcinoma,hyperparathyroidism,surgery

Paratiroid Karsinomu: Ortopedik cerrahi uygulanan geriatrik hastada hiperparatiroidinin nadir bir nedeni

Öz

Paratiroid kanseri nadir görülen ve ciddi hiperparatiroidi tablosu ile seyredebilen bir hastalıktır. Hastalığın ameliyat öncesi dönemde tanınması ve adenomdan ayırımının net olarak yapılması zordur. Paratiroid kanserlerinin tedavisi boyun eksplorasyonuyla birlikte tümör ve aynı taraftaki tiroid dokusunun tamamiyle alınmasını ve ek komşu lenf nodlarının çıkarılmasını kapsar. Başarılı bir cerrahi girişim için en ideali, ameliyat öncesi dönemde tanı konulup hastalığın yerel ve uzak yayılım yapıp yapmadığını belirleyebilmek ve cerrahi çıkarımı ona göre planlamaktır. Bu yazıda, acil ortopedik cerrahi sonrası erken dönemde saptanan, 71 yaşındaki bir rastlantısal paratiroid karsinom olgusu sunuldu. Hastada kesin tanı postoperatif histopatolojik inceleme ile konuldu.

Anahtar Kelimeler

• paratiroid karsinomu,hiperparatiroidizm,cerrahi

References

1. 1. Goswamy J, Lei M, Simo R. Parathyroid carcinoma. Curr Opin Otolaryngol Head Neck Surg 2016;24:155-62.
2. 2. Cetani F, Pardi E, Marcocci C. Update on parathyroid carcinoma. J Endocrinol Invest 2016;39:595-606.
3. 3. Wynne AG, van Heerden J, Carney JA, Fitzpatrick LA. Parathyroid carcinoma: clinical and pathologic features in 43 patients. Medicine (Baltimore) 1992;71:197-205.
4. 4. Cao J, Chen C, Wang QL, Xu JJ, Ge MH. Parathyroid carcinoma: A report of six cases with a brief review of the literature. Oncol Lett 2015;10:3363-8.
5. 5. Koea JB, Shaw JH. Parathyroid cancer: Biology and management. Surg Oncol 1999;8:155-65.
6. 6. Kirkby-Bott J, Lewis P, Harmer CL, Smellie WJ. One stage treatment of parathyroid cancer. Eur J Surg Oncol 2005;31:78-83.
7. 7. Lumachi F, Ermani M, Basso S, Zucchetta P, Borsato N, Favia G. Localization of parathyroid tumours in the minimally invasive era: which technique should be chosen? Population-based analysis of 253 patients undergoing parathyroidectomy and factors affecting parathyroid gland detection.Endocr Relat Cancer 2001;8:63-9.
8. 8. McClenaghan F, Qureshi YA. Parathyroid cancer. Gland Surg 2015;4:329-38.

9. 9. Snell SB, Gaar EE, Stevens SP, Flynn MB. Parathyroid cancer, a continued diagnostic and therapeutic dilemma: report of four cases and review of the literature. Am Surg 2003;69:711-6.
10. 10. Tohme JF, Bilezikian JP. Hypocalcemic emergencies. Endocrinol Metab Clin North Am 1993;22:363-75.
11. 11. Hundahl SA, Fleming ID, Fremgen AM, Menck HR. Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985-1995: A National Cancer Data Base Report. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 1999;86:538-44.