Parathyroid carcinoma: a review.

摘要: Background. Parathyroid carcinoma is a rare entity, comprising fewer than 1% of cases hyperparathyroidism. The disease generally presents with severe hyperparathyroidism and occasionally vocal cord paralysis or firm palpable cervical mass. Methods. The classic histopathologic features trabecular pattern, mitotic figures, thick fibrous bands, capsular vascular invasion are not present in every case but useful assessing whether particular hyperfunctional parathyroid lesion carcinoma. Nevertheless, recognition malignancy at initial operation may be difficult. Management primarily involves complete surgical removal through en bloc resection, which include adjacent central neck structures. Results. Adjuvant radiation therapy has been proven to uniformly effective, several series show results suggestive possible survival advantage. Chemotherapy, genetic, other biomodifying agents remain experimental. Long-term outcome for this neoplasm remains problematic, complications from intractable hypercalcemia constitute the foremost cause death. Reported 5-year survivals have ranged between 70% 85%. Conclusions. Initial success offers greatest opportunity cure. Reoperation recurrence potential short- intermediate-term relief sequelae hypercalcemia, rarely Severely elevated calcium levels should controlled before surgery, much treatment recurrent persistent disease, including reoperative directed control hypercalcemia. © 2010 Wiley Periodicals, Inc. Head Neck,