Naslov
Parathyroid carcinoma
(Karcinom paratireoidne žlijezde)

Autori
Baretić, Maja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, pp prezentacija, stručni

Izvornik
7th International Conference Multidisciplinary approach on Thyroid and Parathyroid Glands / - , 2013

Skup
7th International Conference Multidisciplinary approach on Thyroid and Parathyroid Glands

Mjesto i datum
Zagreb, Hrvatska, 07.11.2013. - 09.11.2013

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
carcinoma of parathyroid gland; hyperparathyroidism
(karcinom paratireoidne žlijezde; hiperparatireoidizam)

Sažetak
Parathyroid carcinoma is rare malignant disease with unknown etiology, sometimes associated with neck irradiation, hypovitaminosis D, hypophosphatemia and/or long standing secondary hyperparathyroidism. The majority of tumors are sporadic, approximately 5% are associated with the autosomal dominant hereditary cancer syndromes ; MEN 1 and 2A, familial isolated hyperparathyroidism and hyperparathyroidism-jaw tumor syndrome. Two cases of parathyroid carcinoma with different clinical course are described. The first one is 24-year-old woman with severe hypercalcaemia in postpartum period due to hyperparathyroidism. She was healthy until than. Right lower parathyroid gland was surgically removed (PHD atypical adenoma measuring 0, 5 cm). A year after the surgery the level of calcium rose, fine needle aspiration of neck solitary mass and a lymph node described metastases of parathyroid carcinoma. In next four years three consecutive surgeries were performed removing all parathyroid tissue, lymph nodes and local metastases. Following surgical procedures there was no hypocalcaemia, shortly after every surgery hypercalcaemia recurred in worse range. Calcium level is hard to control even with combination of pamidronate, cinacalcet and loop diuretic. There are no elements of MEN. The second patient is 63-years old woman with long standing history of nephrolithiasis, hypertension and osteoporosis, elevated calcium level was noticed three years before the surgery. Neck ultrasound showed large left lower parathyroid gland measuring almost 4 cm. After the removal of the gland (PHD parathyroid carcinoma) she severe hypocalcaemia developed. Bone X ray showed typical image of osteitis fibrosis cystica. Follow up for almost a year after the surgery showed no signs of tumor recurrence. She is still taking vitamin D and calcium supplement. A mutation in a tumor suppressor gene HRPT2 is associated with the development of parathyroid carcinoma in hyperparathyroidism-jaw tumor syndrome and familial isolated hyperparathyroidism. HRPT2 mutation is also sometimes related to malignancy in sporadic parathyroid tumors, presenting with aggressive clinical feature. The first patient is probably the HRPT2 carrier, and the second one not.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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