Acta clinica Croatica, Vol. 62. No. 4, 2023.
Original scientific paper
https://doi.org/10.20471/acc.2023.62.04.2
Parathyroid Carcinoma: Ultrasonographic and Clinical Experience
Marina Jadrešić
; Department of Oncology and Nuclear Medicine, Zadar General Hospital, Zadar, Croatia
Sanja Kusačić Kuna
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Center, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
*
Hrvojka Tomić Brzac
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Center, Zagreb, Croatia
Maja Baretić
; Division of Endocrinology and Diabetes, Department of Internal Medicine, Zagreb University Hospital Center, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
Dražen Huić
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Center, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
* Corresponding author.
Abstract
Parathyroid cancer is an extremely rare malignancy that usually leads to hyperparathyroidism.
The aim of this report is to present clinical and ultrasonographic features of tumors in six patients
(5 females; mean age 53.2 years) treated for parathyroid carcinoma at the Department of Nuclear
Medicine during 20 years. Most patients presented with hypercalcemia, and one of them had a previous
history of long-term secondary hyperparathyroidism and was treated with hemodialysis. All patients had
significantly reduced bone density, and two of them presented with typical ‘brown’ tumors involving long
bones of lower extremities. After initial treatment, all patients except for the youngest female patient
were in long-term remission with normal serum calcium and parathyroid hormone levels. Preoperative
imaging procedures such as ultrasound with targeted fine needle-aspiration biopsy and Tc99m-sestamibi
scan helped determine the location and extent of the disease, but definitive diagnosis was made after the
surgery. Parathyroid cancer is a rare form of malignant tumor that is difficult to diagnose preoperatively
due to similar clinical features with benign causes of hyperparathyroidism such as hyperplasia and adenomas,
especially atypical ones that require regular follow-up. Complete surgical resection provides the
best chance of cure, although metastatic disease is possible.
Keywords
Parathyroid carcinoma; Atypical parathyroid adenoma; Hyperparathyroidism; Neck ultrasound
Hrčak ID:
320265
URI
Publication date:
31.12.2023.
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