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International Journal of Surgical Oncology
Volume 2012, Article ID 649148, 5 pages
Research Article

Parathyroid Carcinoma: The Importance of High Clinical Suspicion for a Correct Management

1Division of Endocrine and Bariatric Surgery, San Camillo-Forlanini Hospital, Piazza Carlo Forlanini 1, 00151 Rome, Italy
2Division of Emergency surgery and Trauma, Sapienza University of Rome Umberto I General Hospital, Viale del Policlinico 155, 00161 Rome, Italy

Received 11 May 2012; Accepted 17 July 2012

Academic Editor: Masaki Mori

Copyright © 2012 Gabriele Ricci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Parathyroid carcinoma is an infrequent clinical entity whose diagnosis is very challenge. Indeed a pre-operative or intraoperative diagnosis of parathyroid carcinoma is reported in less than half cases described in the literature. Patients and Methods. A systematic review of pathological reports of our secondary referral hospital was done. From 2003 to 2011 one hundred and forty-four patients were operated for hyperparathyroidism. One patient with atypical adenoma and three patients with parathyroid carcinoma were included in this paper. Results. An en bloc resection of the tumor was performed in three patients. Two of this patients with diagnosis of parathyroid carcinoma are alive with no evidence of recurrence or metastasis, respectively, 48 and 60 months after the operation; one patient with diagnosis of atypical adenoma died for other disease 16 months after the operation. In the last patient a simple parathyroidectomy was performed. After that histology revealed the diagnosis of parathyroid carcinoma the patient underwent reoperation for left hemithyroidectomy and central compartment lymph node clearance. After 30 months a lung lobectomy was done due to metastasis. Conclusion. Parathyroid carcinoma should be considered in the differential diagnosis of PTH-dependent hypercalcemia because optional outcomes are associated with complete resection of the tumor at the time of initial operation.