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Repeated surgery for parathyroid carcinoma


Authors: P. Libánský 1;  J. Tvrdoň 1;  P. Broulík 2;  J. Kubinyi 3;  M. Fialová 1;  S. Adámek 1;  R. Lischke 1
Authors‘ workplace: III. chirurgická klinika 1. LF UK a FN Motol Praha, přednosta: Prof. MUDr. R. Lischke, Ph. D. 1;  III. interní klinika 1. LF UK a VFN Praha, přednosta: Prof. MUDr. Š. Svačina, DrSc., MBA 2;  Ústav nukleární medicíny 1. LF UK a VFN Praha, přednosta: Prof. MUDr. M. Šámal, DrSc. 3
Published in: Rozhl. Chir., 2012, roč. 91, č. 11, s. 601-607.
Category: Original articles

Overview

Introduction:
Carcinoma of the parathyroid glands is a rare cause of primary hyperparathyroidism with an incidence of 1%.

Material and methods:
This article presents an up-to-date review of the literature illustrated by three clinical cases in the form of case reports.

Results:
Parathyroid carcinoma is usually not detected before the first operation. Symptoms of carcinoma of the parathyroid glands are similar to those of benign adenoma. Patients with parathyroid carcinoma usually have a higher level of calcium in serum and a higher level of parathormone. Imaging methods such as neck ultrasound and 99mTc sestamibi scan can help localize pathologically enlarged glands, but they are not capable of distinguishing malignant disease. Fine needle aspiration is not recommended due to the possible associated risk of tumour seeding along the needle track. The radical excision of the tumour together with the ipsilateral thyroid gland removal remains the standard of treatment. Local recurrence is frequent.

Conclusion:
Parathyroid carcinoma is a very rare disease and should be managed surgically in a specialized centre.

Keywords:
Primary hyperparathyroidism – parathyroidectomy – parathyroid carcinoma


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