Parathyroid carcinoma

Abstract

Parathyroid carcinoma (PC) is an extremely rare endocrine tumor that is highly functional and can typically secrete a large amount of parathyroid hormone, causing overt hypercalcemia. As a result, concomitant renal and bone diseases can be seen in over 50% of patients on diagnosis. Although it has a relatively indolent behavior, recurrence after complete surgical resection is not uncommon. The management difficulty lies in performing an appropriate surgery the first time when that diagnosis may not be apparent until after operation or when the disease recurs. Nonetheless, initial surgery offers the best chance of cure. Concomitant lymph node dissection remains controversial unless there is evidence of disease. Advances in medical therapy have greatly improved the management of severe hypercalcemia. A better understanding of the underlying molecular biology, such as its association with HPRT2 gene mutations, has improved the management for patients in diagnosis, risk prediction, and postoperative surveillance.