Parathyroid carcinoma: 50-year experience at The Cleveland Clinic Foundation

• Published in: Cleveland Clinic journal of medicine Vol. 60; no. 4; p. 331
• Main Authors: Hakaim, A G, Esselstyn, Jr, C B
• Format: Journal Article
• Language: English
• Published: United States 01.07.1993
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Combined Modality Therapy; Female; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Male; Middle Aged; Neoplasm Recurrence, Local - therapy; Parathyroid Neoplasms - diagnosis; Parathyroid Neoplasms - mortality; Parathyroid Neoplasms - therapy; Survival Rate
• ISSN: 0891-1150
• DOI: 10.3949/ccjm.60.4.331

Parathyroid carcinoma is rare, with a reported prevalence of 0.6% to 4.0% in patients presumed to have primary hyperparathyroidism. This study examines the long-term results of surgical therapy and combination chemotherapy. From 1938 to 1988, 1260 operations for primary hyperparathyroidism were performed; only six patients (0.47%) were subsequently found to have parathyroid carcinoma. A seventh patient was referred to our institution after the diagnosis of parathyroid carcinoma had been made. All patients had excessive hypercalcemia (serum calcium concentration > 12.0 mg/dL) with a range of 12.3 to 18.3 mg/dL. Locally recurrent tumors causing recurrent hypercalcemia were managed by repeated neck exploration and tumor resection. Six of the seven patients (85%) survived 5 years, while four patients (57%) survived 10 years. Diagnosis of parathyroid carcinoma rests upon postoperative surveillance of patients who have undergone previous neck exploration and resection of apparently benign adenomas. Long-term survival is possible with repeated resection of locally recurrent tumors.