ECE2016 Eposter Presentations Calcium and Vitamin D metabolism (61 abstracts)
Increasing incidence of parathyroid carcinoma – a nationwide study
Eeva M Ryhänen 1 , Helena Leijon 2 , Saara Metso 3 , Eija Eloranta 4 , Pirkko Korsoff 5 , Leo Niskanen 1 , Petteri Ahtiainen 6 , Päivi Kekäläinen 7 , Marjo Tamminen 8 , Raija Ristamäki 9 , Otto Knutar 10 , Eliisa Löyttyniemi 11 , Ilkka Heiskanen 12 , Matti J. Välimäki 1 , Caj Haglund 12, , Johanna Arola 2 & Camilla Schalin-Jäntti 1
1Division of Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 2Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 3Department of Internal Medicine, Tampere University Hospital, Tampere, Finland; 4Department of Internal Medicine, Oulu University Hospital, Oulu, Finland; 5Department of Internal Medicine, Satakunta Central Hospital, Pori, Finland; 6Department of Internal Medicine, Central Finland Central Hospital, Jyväskylä, Finland; 7Department of Internal Medicine, North Carelia Central Hospital, Joensuu, Finland; 8Department of Internal Medicine, Kymenlaakso Central Hospital, Kotka, Finland; 9Department of Oncology, Turku University Hospital, Turku, Finland; 10Department of Internal Medicine, Vaasa Central Hospital, Vaasa, Finland; 11Department of Biostatistics, University of Turku, Turku, Finland; 12Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 13Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland.
Introduction and design: Parathyroid carcinoma (PC) is a rare endocrine malignancy and the diagnosis is difficult. As the incidence seems to be increasing, we examined all cases diagnosed in our country during years 2000–2011 and compared the results to those of atypical parathyroid (AA; n=28) and parathyroid adenomas (A; n=72). All tissue specimens were re-examined.
Results: In 2000–2011, 32 patients were diagnosed with PC in Finland, compared to 19 cases in 1980–1999. Preoperatively, PC patients (median age 61 year, range 17–83) had higher ionized calcium and parathyroid hormone (PTH) concentrations compared to AA and A (1.76, 1.56 and 1.44 mmol/l, P<0.001; and 989, 355 and 160 μmol/l, P<0.001 respectively). They were more often hospitalized for severe hypercalcemia (44% vs 22% and 3%, respectively, P=0.01) and more often suffered from renal (50% vs 48% vs 22%, respectively, P=0.01) and bone involvement (47% vs 15% vs 38%, respectively P=0.002).
Tumor size was larger in PC and AA compared to A (2.95 cm vs 2.0 cm vs 1.6 cm, respectively, P<0.001). Histopathology revealed significant differences in growth patterns, prevalence of fibrous septae, hemosiderin deposits, Ki-67 and parafibromin staining between the subgroups. The hallmarks of PC, i.e vascular, capsular and perineural invasion were present in 72, 72 and 9% of PC tissue specimens, respectively. After primary surgery and a median follow-up of 6.7 years, 9.4% of PC patients had residual and 21% recurrent disease (47% had ≥ 2 operations, 22% radiotherapy, 13% chemotherapy), and 9.4% died of the disease. Overall mortality did not differ between the subgroups (P=0.94).
Conclusions: The prevalence of parathyroid carcinoma has increased significantly in Finland. Parathyroid carcinoma associates with significantly more severe PHPT compared to adenoma, and has distinct histopathological findings.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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