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Cancer of the Parathyroid Glands
Jonathan A. van Heerden, MB, FRCS(C);
Louis H. Weiland, MD;
William H. ReMine, MD, DSc;
Joseph T. Walls, MD;
Don C. Purnell, MD
Arch Surg. 1979;114(4):475-480.
Abstract
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• Hyperfunctioning parathyroid carcinoma is a relatively rare endocrine tumor, accounting for approximately 1% of all cases of primary hyperparathyroidism. The diagnosis is suspected when the tumor is large, parathyroid hormone (iPTH) levels are high, and a palpable tumor is present in the neck. Patients who have recurrence of hyperparathyroidism several months after surgical treatment should be suspected of having a recurrent or persistent parathyroid carcinoma. At operation, a large invasive tumor is usually found. The fibrous, inflammatory-like reaction is the most characteristic indication of malignancy. Even in tumors with minimal invasiveness, the possibility of a carcinoma should be considered if the tumor has mitotic activity and a monotonous instead of a pleomorphic cellular population. If the surgeon can recognize the possibility of parathyroid malignancy and adequately treat the patient during the initial operation, more gratifying results should be obtained.
(Arch Surg 114:475-480, 1979)
Author Affiliations
From the Departments of Surgery (Drs van Heerden and ReMine), Surgical Pathology (Dr Weiland), and Internal Medicine (Drs Walls and Purnell), the Mayo Clinic and Mayo Foundation, Rochester, Minn.
Footnotes
Accepted for publication Nov 29, 1978.
Read before the 86th annual meeting of the Western Surgical Association, Scottsdale, Ariz, Nov 14, 1978.
Reprint requests to Department of Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55901 (Dr van Heerden).
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