Parathyroid Carcinoma: A Clinical And Pathologic Analysis Of 8 Patients In China

Background: The aim of this study is to summarize the clinical and pathological characteristics of parathyroid carcinoma. Methods: A retrospective review of 8 patients with parathyroid carcinoma treated in China was conducted to describe clinical and pathological features. Results: A palpable mass in the central neck was found in 3 patients. 2 patients presented anorexia, fatigue and weight loss beyond 10 kg as their main complaints. 2 patients manifested frequency renal calculus and pancreatitis while another 1 patient presented mainly progressive elevation of ALP and deterioration of the ache on her back and heels. The mean and median intact PTH levels at initial presentation were 1088.3 and 954.2 pg/ml, respectively (range, 159.2+/-2500.0 pg/ml). The mean and median total blood calcium levels were 3.56 and 3.75 mmol/L, respectively (range, 2.65+/-4.09 mmol/L). The mean and median diameters of parathyroid specimens were 34.1 and 36.0 mm, respectively (range, 20.0+/-58.0 mm). Capsular invasion was observed in all these 8 patients; invasion into the adjacent soft tissues was observed in 62.5% of the specimens (n=5). Invasion into vascular, ipsilateral thyroid and lymph positive was observed in 25.0% of the specimens, respectively (n=2). Nerve invasion was observed only in 12.5%(n=1). Conclusion: Parathyroid carcinoma should be suspected when a patient presents severe elevation of total blood calcium and serum PTH, a palpable mass in the central neck area, nephropathy or osteopathy. The most prominent pathological features in this cohort include invasion into capsule, adjacent soft tissues, vessels, nerve and local lymph nodes.