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PubMed1996

Cerebral metastasis of parathyroid carcinoma.

A 54-year-old female presented with a cerebral metastasis of functioning parathyroid carcinoma in the right occipital lobe. After surgical removal of the metastatic tumor, her symptoms of left hemianopsia and hypercalcemia improved. Surgical treatment should be considered in a case of brain metastasis of parathyroid carcinoma associated with secondary hyperparathyroidism to prevent metabolic complications and reduce the mass of the tumor.

Brain Neoplasms↗
PubMedDate not supplied

DNA cytofluorometric analysis using HP/DAPI double staining of parathyroid carcinoma arising in a patient with chronic renal failure and secondary hyperparathyroidism.

A 55-year old female patient on long-term hemodialysis began to suffer from pain in her knees and ankles. An ultrasonographic study showed enlargement of all four parathyroid glands. Serum parathyroid hormone and calcium levels were increased. Parathyroidectomy was performed. The right superior gland was enlarged and adherent to surrounding tissues. The other three glands were slightly enlarged. Histologically, the largest gland was a parathyroid carcinoma because capsular and vascular invasion were observed. To our knowledge, there have been only 13 cases of parathyroid carcinomas arising in patients with chronic renal failure reported in the English literature. To evaluate the characteristics of this tumor, we measured nuclear DNA and protein content using stains for HP (hematoporphyrin)/DAPI (4,6-diamidino-2-phenylindole dihydroporphyrin chloride). The nuclear DNA pattern was typically diploid or tetraploid. The cellular protein content was similar to that seen in the controls. The discrepancy between the histology, indicative of malignancy and the cytofluorometrical findings show that it is difficult to determine the prognosis for patients with secondary hyperparathyroidism and parathyroid carcinomas solely from the results of tumor DNA cytometry.

Carcinoma↗
PubMed1980

Hyperfunctioning parathyroid carcinoma presenting as acute pancreatitis in pregnancy.

Hyperparathyroidism during pregnancy is an uncommon condition. Several case reports and literature reviews in the last two decades have reported only benign tumors but have demonstrated that this disease is associated with significant neonatal morbidity and mortality as well as maternal morbidity. Parathyroid carcinoma is a rare disease entity associated with a much more severe course and prognosis than parathyroid adenomas; it has not been reported in a pregnant woman. We report here a case of a hyperfunctioning parathyroid carcinoma that presented as acute pancreatitis in pregnancy. The details of the case management and outcome in both the patients and infant are discussed. A summary of the literature on the findings and management of parathyroid carcinoma is also discussed in relation to this case report.

Acute Disease↗
PubMed1984

Light and electron microscopic study of nonfunctioning parathyroid carcinoma. Report of a case with a review of the literature.

A case of nonfunctioning parathyroid carcinoma in a 69-year-old female has been studied by light and electron microscopy. The tumor, located on the left side of the anterior neck, was well encapsulated by connective tissue but showed invasion to the capsule and to the thyroid. The tumor cells exhibited a trabecular arrangement surrounded by capillary networks but focally showed several ductal structures. They were polygonal in shape, had a large nucleus showing frequent mitosis and poor cytoplasm containing glycogen. Some tumor cells had clear and abundant cytoplasm, and resembled water-clear cells of the parathyroid. Immunohistochemically, no thyroglobulin was demonstrated in the tumor tissue. Electronmicroscopically, the tumor cells with high N/C ratio contained poorly developed cell organelles and abundant glycogen particles. They were poor in secretory granules and had no conglomeration of lipid. Desmosomes and tonofibrils were observed. The ratio of the reported number of nonfunctioning parathyroid carcinoma to that of functioning one in Japan was compared with that in western countries. No difference of the ratio was found between these two, when identical criteria were employed.

Aged↗
PubMed1997

Multiple brown tumors in parathyroid carcinoma mimicking metastatic bone disease.

An unusual case of multiple brown tumors due to parathyroid carcinoma is reported. The patient presented with lower leg pain. Plain radiographs demonstrated multiple lytic lesions of the lower legs and a Tc-99m MDP bone scan depicted multiple areas of increased uptake suggesting skeletal metastases. Tc-99m sestamibi tumor scintigraphy showed multiple sites of tumor uptake in bones and a large area of increased uptake with a cystic component in the right lower pole of the thyroid gland. An open biopsy from the right tibial lesion revealed a brown tumor. A large parathyroid carcinoma with a necrotic cyst was removed. After parathyroidectomy and right thyroid lobectomy, the patient became free of bone pain and serum PTH levels normalized. A 9-month follow-up Tc-99m MDP bone scan demonstrated less intense uptake in the pelvis, tibia, and fibulae. Nine-month follow-up tumor imaging with Tc-99m MIBI revealed disappearance of the preoperative uptake of multiple brown tumor.

Adult↗
PubMed1992

Immunohistological study of nonfunctional parathyroid carcinoma. Report of a case.

The histological and immunohistological features of a non-functional parathyroid carcinoma obtained from a 56-year-old woman are reported. Macroscopically, the tumor consisted of many small hemorrhagic nodules and showed adhesion to the thyroid gland and esophageal wall. Histologically, the tumor cells resembled parathyroid chief cells, and showed an island-like or sheet-like arrangement, the former showing cystic degeneration and containing hemorrhagic fluid in the extracellular space. Tumor cells resembling water-clear cells and oxyphilic cells were also observed. Most of the tumor cells had glycogen in the cytoplasm. Immunohistologically, the tumor cells showed no staining with anti-thyroglobulin, JT-95 or anti-calcitonin antibodies. However, they were stained with antibodies against chromogranin A (Ch A) and the N-terminal portion of human parathyroid hormone (PTH (N)). The positive staining with anti-PTH (N) antibody disappeared when the antibody was absorbed with excess synthesized human PTH (N). Immunostaining for PTH (N) and Ch A was useful for differentiation of nonfunctional parathyroid carcinoma from thyroid carcinoma and thymoma.

Carcinoma↗
PubMed1986

Parathyroid carcinoma visualized by gallium-67 citrate scintigraphy.

An abnormal uptake of [67Ga]citrate by a palpable neck tumor was observed in a patient with primary hyperparathyroidism. The pathological diagnosis of the surgically resected specimen was parathyroid carcinoma invading the thyroid. The uptake was negative in nine patients with parathyroid adenoma. These results suggest that 67Ga scintigraphy may be useful to differentiate parathyroid carcinoma from benign parathyroid tumor.

Adenoma↗
PubMed2005

Parathyroid carcinoma: a report of two cases and a concise review and update of the literature.

Parathyroid carcinoma is very rare and when diagnosed can be difficult to treat as more than 50 per cent have persistent or recurrent disease. Patients generally present with profound symptoms of hypercalcaemia and a palpable neck mass. We describe a case of parathyroid carcinoma in primary hyperparathyroidism and a case in tertiary hyperparathyroidism in a renal dialysis patient. Most studies in the literature are retrospective but recent trends in presentation, treatment options and complications have been reviewed and are summarized in this paper.

Humans↗
PubMed1997

Parathyroid carcinoma: diagnosis and management.

A patient with severe hypercalcemia and a palpable neck mass is presented. The highest calcium was 18.8 mg/dL. A left lower neck mass was felt on examination. The trachea was deviated to the right side on a chest film. A barium swallow demonstrated an indentation on the left side of the esophagus. An en-bloc resection of the mass including the thyroid lobe, the strap muscles, and the recurrent laryngeal nerve was done. The pathologic specimen revealed parathyroid carcinoma with dense fibrous septae, invasion of the capsule, and vascular invasion. The patient is alive and without evidence of hypercalcemia or recurrence of the disease 23 years after surgery, probably the longest survivor with carcinoma of the parathyroid gland. Parathyroid carcinoma should be suspected in any patient with severe hypercalcemia and a palpable mass. The best chance for cure is obtained by performing a wide surgical excision during the initial operation.

Female↗
PubMed1991

Metastatic parathyroid carcinoma: dilemmas in management.

The incidence of parathyroid carcinoma in patients surgically treated for primary hyperparathyroidism at the University of Michigan Hospital was 0.4% during an 18-year period. The courses of the five patients with metastatic disease are described. Histologic reevaluation and assessment of the DNA ploidy pattern were performed in each case. Localization studies preceded all reexplorations. The number of operative procedures in each patient ranged from two to 10. Two patients are living with recurrent disease and one has been disease free for 42 months. Two patients died after 2 and 12 years, respectively. Three patients had aneuploid tumors; one had a diploid tumor. One patient had both aneuploid and diploid cell populations. Dilemmas in diagnosis, localization, and medical and surgical management were encountered in patients with metastatic carcinoma. The chosen treatment should be evaluated individually in each case because of the variability in aggressiveness of this malignancy. Surgical resection proved most effective in some of these patients for both local and distant recurrences. Bisphosphonates and gallium nitrate have been reported to be effective in controlling hypercalcemia. Only the former had some effect in one of our patients.

Adult↗
PubMed1989

A case of parathyroid carcinoma visualized by 67Ga citrate and 201Tl chloride scintigraphy.

Both 67Ga citrate and 201Tl chloride accumulated in a parathyroid tumor of a 62 year-old woman with primary hyperparathyroidism. Histological studies disclosed that the tumor was a parathyroid carcinoma. The use of both tumor scanning agents, 67Ga citrate and 201Tl chloride to visualize parathyroid carcinoma in a patient with primary hyperparathyroidism has not been reported as far as we could determine.

Citrates↗
PubMed1998

Parathyroid carcinoma: sixteen new cases and suggestions for correct management.

We undertook a retrospective study in 16 patients with parathyroid carcinoma, with the aim of conveying experience from management of this rare cause of hyperparathyroidism (HPT). From 1980 to 1996 we operated on 309 patients with HPT, 290 of whom had primary HPT, and parathyroid carcinoma was diagnosed in 16 (5.2%) cases. In none was the malignancy diagnosed preoperatively. The average serum calcium and parathyroid hormone levels were significantly higher (p < 0.05) than in patients with parathyroid adenoma, and the mean tumor size was 2.9 cm (median 2.5 cm, range 1.5-4.5 cm). Twenty-eight operations were performed with resulting normalization of serum calcium levels for more than 6 months in 11 patients. Six patients presented prolonged postoperative hypocalcemia (2-10 months), and five patients had persistent HPT. Ten patients experienced recurrent disease; the median disease-free period was 24 months (range 4-72 months). None of the patients was treated with chemotherapy, one patient underwent radiation therapy (50 Gy in 25 sessions) but required reoperation for local recurrence 4 months later. Three patients are still alive (two with recurrence). Average survival was 40 months (median 31 months, range 11-131 months).

Adult↗
PubMed1999

Parathyroid carcinoma secondary to prolonged hyperplasia in chronic renal failure and in coeliac disease.

The presentation of parathyroid carcinoma in patients with chronic renal failure is rare, although with improvements in life expectancy associated with this condition there have now been 12 reported cases, including the first case we report here. It has been proposed that in these cases there has been a malignant transformation of benign parathyroid hyperplastic tissue. We also report the first case of parathyroid carcinoma associated with coeliac disease and suggest that the same mechanism may be responsible. We review the presentation, diagnosis, treatment and natural history of the disease.

Adult↗
PubMed1998

A rare manifestation of parathyroid carcinoma presenting as a cystic neck mass.

Parathyroid carcinoma is a rare endocrine neoplasm. An unusual case is reported where a patient presented with a cystic neck mass and hypercalcemia. A review of the Connecticut Tumor Registry data revealed that four cases were encountered statewide over years 1988 to 1993. A brief overview of the current literature follows.

Cysts↗
PubMed1983

A case of functioning parathyroid carcinoma with hypereninemic hypertension.

A case of 49-year-old Japanese house wife with a functioning parathyroid carcinoma was reported. Because of lack of bone and renal involvements, she was classified as chemical type of primary hyperparathyroidism. Abnormally high levels of serum calcium and a small palpable tumor on the right anterior neck had suspected a functioning parathyroid carcinoma, which was proved histologically after operation. Preoperatively, she had a labile hypertension (116-190/68-126 mmHg) with high plasma renin activity (PRA; 2.3-8.4 ng/ml/h). The marked responses of PRA to furosemide and captopril were accompanied by inappropriate low response of aldosterone. After removal of the tumor, her blood pressure returned to normal with lowered PRA and normal serum calcium. These observations strongly suggested that her elevated PRA might be a main role to yield hypertension.

Angiotensin II↗
PubMed1986

Parathyroid carcinoma: high-frequency sonographic features.

The authors reviewed the features on high-frequency (10 MHz), realtime sonograms of parathyroid carcinoma in eight patients to identify characteristics that could preoperatively distinguish malignant from benign lesions. The mean diameter of the eight carcinomas was 2.4 cm. They were typically ovoid or round and had a lobulated contour. The carcinomas were predominantly hypoechoic relative to the adjacent thyroid, but two of the eight contained both hypoechoic and hyperechoic regions, and three contained cystic spaces. Two carcinomas were grossly invasive on ultrasonographic (US) examination, although seven were proved histologically to be invasive. High-resolution US provides a noninvasive means to localize primary and locally recurrent parathyroid carcinomas preoperatively but fails to distinguish carcinomas from large adenomas reliably, except in cases with extensive invasion of adjacent structures.

Adult↗
PubMed2026

Comprehensive genomic profiling and tumor mutational burden in parathyroid carcinoma: a nationwide real-world study from Japan.

PURPOSE: Parathyroid carcinoma (PC) is an extremely rare endocrine malignancy with limited treatment options for unresectable or recurrent cases. With the increasing use of comprehensive genomic profiling (CGP), treatment based on genomic findings is becoming more common. However, the frequency and clinical significance of elevated tumor mutational burden (TMB) in PC remain unclear because previous studies have been limited by small sample sizes. METHODS: We retrospectively analyzed genomic and clinical data of patients with PC registered in the Center for Cancer Genomics and Advanced Therapeutics database in Japan between June 2019 and March 2025. TMB values were obtained as reported by each CGP assay. TMB-H was defined as TMB&#x2009;&#x2265;&#x2009;10 mut/Mb for descriptive analyses. We also assessed genomic alterations, microsatellite instability (MSI) status, and clinicogenomic characteristics. RESULTS: Twenty-five patients with PC were included. The median assay-reported TMB was 4.0 mut/Mb (range, 0-35). Seven tumors (28.0%) had assay-reported TMB values of &#x2265;&#x2009;10 mut/Mb, including three (12.0%) with TMB&#x2009;&#x2265;&#x2009;20 mut/Mb. The most frequently altered genes were CDC73 (40%), TP53 (32%), and MEN1 (24%). No co-alterations were observed between CDC73 and MEN1 or between CDC73 and TP53. One tumor was MSI-high and was included in the TMB-H group. POLE alterations were detected in three cases, including two tumors in the TMB-H group. CONCLUSION: This nationwide, real-world study demonstrated that a subset of PCs showed elevated assay-reported TMB values and genomic features potentially related to abnormalities in DNA replication or repair pathways. These findings support the clinical relevance of comprehensive genomic profiling in identifying the molecular heterogeneity and potential therapeutic opportunities for this rare malignancy.

Humans↗