PARATHYROID CANCER. A REPORT OF THREE CASES
S. Lunca *, G. Bouras **
M.R. Diaconescu, M. Glod, I. Costea, Mirela Grigorovici, A. Covic*
Fourth Surgical Clinic,
Nefrology Clinic*
University of Medicine and Pharmacy Iasi
Jurnalul de chirurgie 2005; 1 (2):176-182
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Abstract:
The parathyroid carcinoma (PTCa) is a rare and confusing condition
mentioned in literature with incidence of 0,5-5% in the etiology of
PT hyperfunction. Three cases representing 8,9% (!) from our experience
in PT surgery are presented.
The first one was a 45 years old woman which at 40 months after resection
of a right PT “adenoma” (15g) presents a clinical and
biological recurrence of hyperparathyroidism (HP). At surgical re-exploration
a new “tumour” (5g) was found on the same side and an
“en block” resection including also the right side lobe
of the thyroid was done. The paraffin sections identified a PTCa.
The second case was a young female (32 years) with a severe generalized
bone disease and important hypercalcemia. A giant PT gland tumor of
35 g was easy and completely removed. The histological examination
showed evidence of a PTCa she survived 14 months.
Finally the third patient was a 49 year old man with tertiary HP
who is receiving maintenance hemodyalisis from 13 years. Ultrasonography
revealed a thyroid nodule of 38 mm diameter of the left lobe. At operation
only three PT glands was found and excised together with the “nodule”.
The definitive examination of the paraffin embedded material showed
a PTCa. In all our three cases the surgery was the only beneficial
therapy and two or three are still alive after four and one year respectively.
Patients with PTCA have clinically severe hyperparathyroidism related
to the high calcium levels in the plasma and only the recognition
and en bloc removal of the tumor at the time of the first operation
assured best prognosis of this condition.
KEYWORDS: PARATHYROID CANCER, HYPERPARATHYROIDISM,
HYPERCALCEMIA
Correspondence: Prof. Dr. M.R. Diaconescu
, Clinica a IV-a Chirurgie, Spitalul Clinic C.F.R, Str. Garabet Ibraileanu
nr.1, e-mail: mr_diaconescu@yahoo.com
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