Parathyroid Carcinoma: a Rare Cause of Hyperparathyroidism

Year 2010, Volume: 2010 Issue: 4, 318 - 322, 01.04.2010

Atakan Sezer Fulya Öz Puyan Ali Sarıkaya Mehmet Emin İrfanoğlu

https://doi.org/10.5174/tutfd.2008.00943.1

Abstract

Parathyroid carcinoma is one of the rare causes of primary hyperparathyroidism. These tumors account for 0.4-1% of all cases of primary hyperparathyroidism and it is difficult to distinguish from benign disorders of parathyroid glands. A 61-year-old female patient previously operated for parathyroid adenoma admitted to our clinic with parathyroid carcinoma suspicion. Clinical examination revealed a mass in the right half of the thyroid gland and radiological investigation supported the diagnosis. She underwent surgery and thyroidectomy, parathyroidectomy, neck dissection and strap muscle excision were performed. The pathological investigation revealed parathyroid carcinoma. The patient was discharged uneventful with oral calcitriol and calcium replacement. Paratiroid karsinomları primer hiperparatiroidinin nadir nedenleri arasında yer alır. Bu tümörler tüm primer hiperparatiroidilerin %0.4-1'inde görülür ve paratiroid bezininin diğer hastalıklarından ayrımı zordur. Daha once paratiroid adenoma tanısı ile opere olan 61 yaşında bayan hasta kliniğimize paratiroid karsinomu şüphesi ile başvurdu. Hastanın klinik muayenesinde tiroid glandın sağ tarafında kitle palpe edildi ve radyolojik incelemeler tanıyı destekledi. Hastaya tiroidektomi, paratiroidektomi, boyun diseksiyonu ve strap kas eksizyonu yapıldı ve patolojik incelemede paratiroid karsinomu tanısı kondu. Hasta oral kalsiyum ve kalsitriol tedavisi ile sorunsuz olarak taburcu edildi.

Keywords

Parathyroid; carcinoma; hyperparathyroidism

Paratiroid Karsinomu: Hiperparatiroidinin Nadir Bir Nedeni

Abstract

Paratiroid karsinomları primer hiperparatiroidinin nadir nedenleri arasında yer alır. Bu tümörler tüm primer hiperparatiroidilerin %0.4-1'inde görülür ve paratiroid bezininin diğer hastalıklarından ayrımı zordur. Daha once paratiroid adenoma tanısı ile opere olan 61 yaşında bayan hasta kliniğimize paratiroid karsinomu şüphesi ile başvurdu. Hastanın klinik muayenesinde tiroid glandın sağ tarafında kitle palpe edildi ve radyolojik incelemeler tanıyı destekledi. Hastaya tiroidektomi, paratiroidektomi, boyun diseksiyonu ve strap kas eksizyonu yapıldı ve patolojik incelemede paratiroid karsinomu tanısı kondu. Hasta oral kalsiyum ve kalsitriol tedavisi ile sorunsuz olarak taburcu edildi.

Keywords

Paratiroid, karsinom, hiperparatiroidi

References

• Lee JE. Predicting the presence of parathyroid carcinoma. Ann Surg Oncol 2005;12:513-4.
• Shane E. Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab 2001;86:485-93.
• Kebebew E, Arici C, Duh QY, Clark OH. Localization and reoperation results for persistent and recurrent parathyroid carcinoma. Arch Surg 2001;136:878-85.
• Atakan S, Ibis C, Irfanoglu ME. Hiperparatiroidizm nedeni ile ameliyat edilen hastalarımızın sonuçları. Cerrahpaşa Tıp Fakültesi Dergisi 2007;38:90-4.
• Sandelin K, Auer G, Bondeson L, Grimelius L, Farnebo LO. Prognostic factors in parathyroid cancer: a review of 95 cases. World J Surg 1992;16:724-31.
• Rao SR, Shaha AR, Singh B, Rinaldo A, Ferlito A. Management of cancer of the parathyroid. Acta Otolaryngol 2002;122:448-52.
• Ireland JP, Fleming SJ, Levison DA, Cattell WR, Baker LR. Parathyroid carcinoma associated with chronic renal fail- ure and previous radiotherapy to the neck. J Clin Pathol 1985;38:1114-8.
• Haghighi P, Astarita RW, Wepsic HT, Wolf PL. Concurrent primary parathyroid hyperplasia and parathyroid carci- noma. Arch Pathol Lab Med 1983;107:349-50.
• Wassif WS, Moniz CF, Friedman E, Wong S, Weber G, Nordenskjöld M, et al. Familial isolated hyperparathyroid- ism: a distinct genetic entity with an increased risk of para- thyroid cancer. J Clin Endocrinol Metab 1993;77:1485-9.
• Szabó J, Heath B, Hill VM, Jackson CE, Zarbo RJ, Mallette LE, et al. Hereditary hyperparathyroidism-jaw tumor syn- drome: the endocrine tumor gene HRPT2 maps to chromo- some 1q21-q31. Am J Hum Genet 1995;56:944-50.
• Jiménez-Garcia A, Milán JA, García-Escudero A, Marín- Velarde C, Cantillana J, Echenique-Elizondo M. Parathyroid carcinoma on transplanted parathyroid tissue after total parathyroidectomy for renal hyperparathyroidism. Am J Clin Oncol 2006;29:207-8.
• Fernandez-Ranvier GG, Khanafshar E, Jensen K, Zarnegar R, Lee J, Kebebew E, et al. Parathyroid carcinoma, atypi- cal parathyroid adenoma, or parathyromatosis? Cancer 2007;110:255-64.
• Schantz A, Castleman B. Parathyroid carcinoma. A study of 70 cases. Cancer 1973;31:600-5.
• Iwata T, Inoue K, Morita R, Mizuguchi S, Tsukioka T, Onoda N, et al. Functional large parathyroid carcinoma extending into the superior mediastinum. Ann Thorac Cardiovasc Surg 2008;14:112-5.
• Wang CA, Gaz RD. Natural history of parathyroid car- cinoma. Diagnosis, treatment, and results. Am J Surg 1985;149:522-7.
• McCance DR, Kenny BD, Sloan JM, Russell CF, Hadden DR. Parathyroid carcinoma: a review. J R Soc Med 1987;80:505-9.
• Johnston LB, Carroll MJ, Britton KE, Lowe DG, Shand W, Besser GM, et al. The accuracy of parathyroid gland localiza- tion in primary hyperparathyroidism using sestamibi radio- nuclide imaging. J Clin Endocrinol Metab 1996;81:346-52.
• Fujimoto Y, Obara T, Ito Y, Kodama T, Nobori M, Ebihara S. Localization and surgical resection of metastatic parathy- roid carcinoma. World J Surg 1986;10:539-47.
• Munson ND, Foote RL, Northcutt RC, Tiegs RD, Fitzpatrick LA, Grant CS, et al. Parathyroid carcinoma: is there a role for adjuvant radiation therapy? Cancer 2003;98:2378-84.
• Goepfert H, Smart CR, Rochlin DB. Metastatic parathyroid carcinoma and hormonal chemotherapy. Case report and response to hexestrol. Ann Surg 1966;164:917-20.
• Bukowski RM, Sheeler L, Cunningham J, Esselstyn C. Successful combination chemotherapy for metastatic para- thyroid carcinoma. Arch Intern Med 1984;144:399-400.
• Jüngst D. Disodium clodronate effective in management of severe hypercalcaemia caused by parathyroid carcinoma. Lancet 1984;2:1043.
• Jacobs TP, Siris ES, Bilezikian JP, Baquiran DC, Shane E, Canfield RE. Hypercalcemia of malignancy: treatment with intravenous dichloromethylene diphosphonate. Ann Intern Med 1981;94:312-6.