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

Table 2

Main clinical features of patients with parathyroid carcinoma (PC) and atypical adenoma (AA).

	Patient 1 (PC)	Patient 2 (PC)	Patient 3 (PC)	Patient 4 (AA)
Age	46	69	64	54
Gender	F	M	M	M
Symptoms	Renal +; Bones –; Psychiatric +	Renal +; Bones +; Psychiatric +	Renal +; Bones +; Psychiatric −	Renal −; Bones +; Psychiatric +
Palpable mass	No	No	Yes	Yes
Calcium (mg/dL)	14,0	13,0	14,2	13,2
PTH (pg/mL)	898	184	620	475
Type of resection	En bloc resection with the ipsilateral lobe + paratracheal lymphadenectomy	(1) MIVAP; (2) After 3 weeks thyroid loboistmectomy + paratracheal lymphadenectomy	En bloc resection with the ipsilateral lobe	En bloc resection with the ipsilateral lobe
Affected gland	Left superior	Left superior	Left inferior	Right inferior
Tumor size	2,7 × 1,4 × 2,5 cm	1,9 × 1,7 × 1,4 cm	3,6 × 2 × 2,7 cm	3 × 1,7 × 1,2 cm
Outcome	Alive, no evidence of disease at 60 months of followup	Alive, surgically treated lung metastasis, rise in calcium/PTH levels without evidence of recurrence at imaging investigations at 36 months of followup	Alive, no evidence of disease at 48 months of followup	Died for other disease