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KMID : 1104520190190020035
Journal of Endocrine Surgery
2019 Volume.19 No. 2 p.35 ~ p.44
Parathyroid Cancer: Comparison with Benign Hyperparathyroidism
Seok Jae-Yeon

Lee Joon-Hyop
Lee Si-Hoon
Kang Suk-Ha
Chung Yoo-Seung
Abstract
Purpose: The preoperative diagnosis of parathyroid cancer (PC) is challenging. The purpose of this study was to identify the differences between PC and benign primary hyperparathyroidism.

Methods: The medical records of 85 hyperparathyroidism patients that underwent surgery between 2001 and 2017 were retrospectively reviewed.

Results: Seven of the 85 were diagnosed with PC. Mean age was 53.0¡¾13.0 years and 66 (77.6%) were women. Follow-up duration was 52.9¡¾44.4 months. Tumors were larger (3.50¡¾1.26 cm vs. 2.10¡¾0.84 cm, P=0.002), and intact parathyroid hormone (iPTH) (1,142.8¡¾524.5 pg/mL vs. 461.2¡¾513.5 pg/mL, P=0.002) and alkaline phosphatase (ALP) (398.6¡¾493.6 U/L vs. 166.7¡¾181.1 U/L, P=0.01) levels were higher in cancer patients than in benign primary hyperparathyroidism. Intraoperatively, adhesion to surrounding soft tissue or the thyroid gland was detected more frequently in cancer (85.7% vs. 12.8%, P<0.001). Two patients experienced recurrences and one of them died from PC.

Conclusion: PC patients had larger tumors size, and higher serum iPTH and ALP levels. Intraoperative detection of adhesion to surrounding soft tissue/thyroid importantly raised suspicion of PC. Surgeons operating for hyperparathyroidism should be prepared to perform an appropriate en bloc resection initially upon suspicion of PC.
KEYWORD
Parathyroid neoplasms, Hyperparathyroidism, Parathyroid cancer
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