PARATHYROID
CANCER – SUSPICIOUS FINDINGS FOR PREOPERATIVE OR INTRAOPERATIVE RECOGNITION
Primary hyperparathyroidism
may rarely be due to parathyroid carcinoma. This rare etiology should be suspected
based on the following findings:
PREOPERATIVELY
ü Significant increase of serum
calcium levels (> 14 mg/dL)
ü Significant increase of parathormone
levels (> 3 times the normal value)
INTRAOPERATIVELY
ü Large parathyroid mass measuring
> 3 cm in diameter
ü Firm mass, with irregular borders
ü Invasion of adjacent tissues
(ipsilateral lobe of the thyroid gland, muscles, recurrent laryngeal nerve,
esophagus, trachea etc)
ü Cystic degeneration
ü Presence of lymphatic spread (rare
in parathyroid cancer, present in < 5 % of cases)
The
recognition of parathyroid carcinoma preoperatively or during surgery has
clinical significance, since extensive surgical resection could be required to
achieve radical eradication of the disease and cure of the patient.
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