FINE-NEEDLE
ASPIRATION (FNA) CYTOLOGY AND PARATHYROID CANCER
FNA should
be avoided when parathyroid cancer (PC) is suspected because of the increased
potential procedure-related morbidity (bleeding and tumor seeding along the
needle tract) and the difficulty in differentiating between benign and
malignant parathyroid lesions on FNA cytology. Diagnosis of PC should be
suspected in the presence of profound hypercalcemia (> 14 mg/dL) and very
high PTH levels (greater than five times the upper limit of normal, usually
> 300 pg/mL). About half of patients with PC will present with a hard mass
in the neck. Diagnosis of PC is based on clinical manifestations, blood tests,
and findings during surgery.
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