1 research outputs found
The carcinoma of parathyroid gland
Parathyroid carcinoma constitutes less than 1% of primary
hyperparathyroidism. The exact etiology is not known. Prior radiation
to neck, chronic renal failure and genetic factors are thought to play
a role. The male to female ratio is one. Parathyroid carcinomas are
slow growing, have a tendency to recur locally and metastasize late.
95% of parathyroid carcinomas are functioning. The major distinguishing
features of malignant hyperparathyroidism are presence of a palpable
mass in the neck and features of severe hypercalcemia. By far the most
important test to diagnose primary hyperparathyroidism is serum level
of Immunoreactive PTH. The diagnosis of primary hyperparathyroidism is
essentially clinical and biochemical. Biopsy is not necessary before
definitive surgery. CT scan appears to be the best investigation for
detecting the primary tumor, its local extent and metastases. Most of
the symptoms are attributable to hypercalcemia, which needs to be
treated aggressively. Early surgery with 'en bloc' resection of the
tumor is the only potentially curative treatment. Parathyroid carcinoma
is traditionally said to be resistant to radiotherapy. Various
chemotherapeutic agents have been used with partial anecdotal
responses. The 5-year survival is about 50% and 10-year survival varies
from 13-49%