Incidence and prognosis of parathyroid gland carcinoma: A population-based study in The Netherlands estimating the preoperative diagnosis

• Published in: The American journal of surgery Vol. 202; no. 5; pp. 590 - 597
• Main Authors: Schaapveld, Michael, M.D., Ph.D, Jorna, Francisca H., M.D, Aben, Katja K.H., M.D., Ph.D, Haak, Harm R., M.D., Ph.D, Plukker, John T.M., M.D., Ph.D, Links, Thera P., M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2011; Elsevier; Elsevier Limited
• Subjects: Adenoma - diagnosis; Adenoma - epidemiology; Aged; Aged, 80 and over; Biological and medical sciences; Calcium; Calcium - blood; Carcinoma - diagnosis; Carcinoma - epidemiology; Carcinoma - therapy; Cohort Studies; Creatinine - blood; Diagnosis; Disease-Free Survival; Endocrinopathies; Epidemiology; Female; General aspects; Humans; Hypercalcemia; Hyperparathyroidism; Incidence; Male; Malignancy; Malignant tumors; Medical prognosis; Medical sciences; Middle Aged; Neck; Neoplasm Recurrence, Local - epidemiology; Neoplasm Staging; Netherlands - epidemiology; Neuroendocrine tumors; Parathyroid; Parathyroid carcinoma; Parathyroid gland; Parathyroid hormone; Parathyroid Hormone - blood; Parathyroid Neoplasms - diagnosis; Parathyroid Neoplasms - epidemiology; Parathyroid Neoplasms - therapy; Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases); Patients; Population studies; Population-based studies; Predictive Value of Tests; Prognosis; Public health. Hygiene; Public health. Hygiene-occupational medicine; Radiotherapy, Adjuvant; Recurrence; Registries; Retrospective Studies; Studies; Surgery; Survival; Thyroid cancer; Thyroid gland; Netherlands; Europe; Recurrence; Diagnosis; Survival; Hyperparathyroidism; Parathyroid carcinoma; Incidence; Endocrinopathy; Relapse; Prognosis; Estimation; Malignant tumor; Epidemiology; Statistical study; Medicine; Treatment; Parathyroid diseases; Parathyroid cancer; Surgery; Parathyroid glands; Preoperative; Cancer
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2010.09.025

Abstract Background Parathyroid carcinoma is a rare malignancy and generally is diagnosed after surgery for primary hyperparathyroidism. Lack of a preoperative diagnosis and ill-considered surgical planning with its impact on survival are ill-described. Methods In a retrospective population-based cohort study the clinical features, treatment, recurrences, and survival of 41 parathyroid cancer patients are reported and compared with characteristics of patients with primary hyperparathyroidism. Results Patients with parathyroid carcinoma had significantly higher serum parathyroid hormone and calcium levels compared with patients with primary hyperparathyroidism. Nineteen patients (46%) had a palpable neck mass. A parathyroid hormone level more than 3 times the upper normal limits was suspicious and levels more than 10 times carried a positive predictive value of 84% for carcinoma. Ten-year recurrence-free and disease-specific survival rates were 71% and 79%, respectively. Conclusions Parathyroid hormone levels of more than 3 times upper normal limits, palpable neck mass, and profound hypercalcemia are suspicious signs of carcinoma necessitating surgical exploration by an experienced surgeon.