Challenges in parathyroid cancers: a review

• Main Authors: Sujith Indeewara Wijerathne, Rajeev Parameswaran
• Format: Article
• Language: English
• Published: Pusat Perubatan Universiti Kebangsaan Malaysia 2018
• Online Access: http://journalarticle.ukm.my/12550/1/2._sujith__rajeev.pdf; http://journalarticle.ukm.my/12550/; http://jsurgacad.com/toc/8/1
• Institution: Universiti Kebangsaan Malaysia

Parathyroid carcinomas are rare neoplasms, with a reported incidence of less than 1% of cases of primary hyperparathyroidism. Diagnosis and treatment of parathyroid carcinoma remains a challenge, as many of the pathologic features are neither sensitive nor specific in differentiating from benign parathyroid lesions. The rule of 3’s (serum calcium of more than 3mmol/L and size of the adenoma being more than 3cm) is helpful in risk identifying a cancer. Ultrasound of the neck and Tc-99m pertechnetate/Tc-99m sestamibi (MIBI) scan remains the two main modalities of investigation of parathyroid disease. Although en-bloc treatment is recommended for parathyroid cancer, it is only performed in up to 12% of cases. This review illustrates the challenges in diagnosis and treatment of parathyroid carcinoma.