ISSN 1849-9031 (Online)

ISSN 1849-8922    (Print)

Parathyroid carcinoma: a diagnostic and treatment challenge.
Lora Stanka Kirigin Biloš, Draško Pavlović, Frieder Kellar.


Parathyroid carcinoma (PC) is a rare endocrine tumor, accounting for less than 1% of primary hyperparathyroidism (pHPT) cases. The clinical presentation is often indistinguishable from other causes of pHPT, leading to a delay in diagnosis and less then optimal surgical management. Early enbloc surgical resection is the recommended surgical procedure, but because the diagnosis of PC is usually made retrospectively, the most common surgical technique performed is a simple parathyroidectomy, which results in an increase in recurrence and mortality. Some centers routinely perform intra-operative histological examination of all parathyroid tissue. Hypercalcemia is the principal cause of morbidity and mortality in PCs and can be treated with repeated surgeries, bisphosphonates, calicimimetics, or newer therapies such as denosumab. There is little evidence that supports the role of chemotherapy or radiotherapy in the treatment of PC. This review will focus on the diagnosis and management of PC and will provide a diagnostic and treatment algorithm.