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KMID : 1120320190050000016
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Osteoporosis and Sarcopenia
2019 Volume.5 No. 0 p.16 ~ p.16
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Minimally invasive parathyroid carcinoma - A missing entity between parathyroid adenoma and carcinoma: Scintigraphic and histological features
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Singh Priyanka
Vadi Shelvin Kumar
Saikia Uma Nahar
Sood Ashwani
Dahiya Divya
Arvindkumar Sapara Mohin
Bhadada Sanjay Kumar
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Abstract
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Introduction: Minimally invasive parathyroid carcinoma (MIPC) patients were clinically and biochemically comparable with parathyroid adenoma (PA), histopathologically differs from PA. MIPC is intermediate of PA and parathyroid carcinoma. In literature there is no definite criteria to diagnose. Our aim was to evaluate and characterize the imaging and histological characteristics of MIPC.
Methodology: Patients with MIPC were recruited from Indian PHPT registry (indianphptregistry.com) January 2014?July 2018 retrospectively. Histological features of MIPC emphasizing on the importance of the trabecular pattern, capsular invasion, vascular invasion, nuclear pleomorphism and Ki 67. The imaging finding of these 10 patients were reviewed.
Results and Discussion: The mean age of the 10 patients (3 males) was 39.9?±?11.3 years (range: 17?50). All patients had an elevated preoperative iPTH level ranging from 427 to 2138 pg/ml (mean: 1328?±?666.6). MIBI study done for localization showed intensely avid and enlarged parathyroid lesions in all patients (LIPT in 6, RIPT in 3 and ectopic mediastinal in 1) with mean size of the of 2.8?±?1.1 cm. The mean of maximum standardized uptake value (SUV max) of MIPC was 6.7?±?1.1 (range 6.0?8.3). The mean tumor weight of 12?±?9.5 g (range: 1.09?28). All MIPC patients were identified: 80% with capsular invasion only and 50% with vascular invasion but there was no local invasion, or lymph node or distant metastasis. The Ki-67 labeling index was 3.2 2.7 with range of 1.1?10.
Conclusion: The MIPC appears to be a distinct entity with more aggressive clinical, biochemical, scintigraphy and histopathological features than PA though less aggressive than widely invasive parathyroid carcinoma.
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