Endocrine Abstracts

Parathyroid carcinoma (PC) is very rare and difficult to differentiate from atypical parathyroid adenoma (AA). En-bloc surgical resection is recommended, but most cases are diagnosed after non-radical surgery, and it is recommended to expand it. Given the rarity of the cases, the difficulty in the histological diagnosis (HD) and the unpredictability of the evolution, we analyzed our experience with PC and AA.

Material and methods: We conducted a retrospective analysis of 20 patients whom received surgery for primary hyperparathyroidism (PHP) from 2000 to 2022 with an HD of PC and AA. We collected data from age, sex, ultrasound data, parathyroid scintigraphy, clinical signs, pre- and post-surgery tests (PTH, calcium, phosphorus, and vitamin D), type of surgery, persistence of disease, and survival. Statistical analysis was done using SPSS®.

Results: Of our 20 patients, 11 were men and 9 women. HD of PC 12 and AA in 8. Age 61 years (28–77). We found no differences between PC or AA in pre-surgery, ultrasound, scintigraphy, clinical data, type of surgery (5 en bloc and 15 parathyroidectomies) laboratory parameters, tumor size, Ki67 or survival. We found differences in biochemical parameters before and after surgery with no differences according to AP or type of surgery. All patients are still alive. We have not expanded surgery in any case of PC diagnosed after parathyroidectomy.

Conclusions: We did not find clinical, biochemical or imaging characteristics that guide the diagnosis of PC or AA pre-surgery. The clinical and analytical evolution of PHP after surgery is independent of the HD in cases of AA and PC in our setting. Parathyroidectomy achieved the same survival as en bloc surgery.