Controversies in the management of parathyroid carcinoma: A case series and review of the literature

被引:24
作者
Medas, Fabio [1 ]
Erdas, Enrico [1 ]
Loi, Giulia [1 ]
Podda, Francesco [1 ]
Pisano, Giuseppe [1 ]
Nicolosi, Angelo [1 ]
Calo, Pietro Giorgio [1 ]
机构
[1] Univ Cagliari, Dept Surg Sci, SS 554, I-09042 Monserrato, CA, Italy
关键词
Parathyroid carcinoma; Parathyroid surgery; Primary hyperparathyroidism; FOCUSED PARATHYROIDECTOMY; PROGNOSTIC-FACTORS; HORMONE ASSAY; CANCER; HYPERPARATHYROIDISM; DIAGNOSIS; SURVIVAL;
D O I
10.1016/j.ijsu.2015.12.040
中图分类号
R61 [外科手术学];
学科分类号
摘要
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. (c) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:S94 / S98
页数:5
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