Filomena Cetani

Laura Gianotti

Frontiers in Endocrinology

Directory of Open Access Journals

Frontiers in EndocrinologyOPEN ACCESSEDITED AND REVIEWED BYTerry Francis Davies,Icahn School of Medicine at Mount Sinai,United States*CORRESPONDENCELaura GianottiLaura.gianotti@unito.itSPECIALTY SECTIONThis article was submitted toThyroid Endocrinology,a section of the journalFrontiers in EndocrinologyRECEIVED 11 February 2023ACCEPTED 20 February 2023PUBLISHED 24 February 2023CITATIONGianotti L and Cetani F (2023) Editorial:Parathyroid atypical adenomasand carcinoma: An update onclinical management.Front. Endocrinol. 14:1163996.doi: 10.3389/fendo.2023.1163996COPYRIGHT© 2023 Gianotti and Cetani. This is anopen-access article distributed under theterms of the Creative Commons AttributionLicense (CC BY). The use, distribution orreproduction in other forums is permitted,provided the original author(s) and thecopyright owner(s) are credited and thatthe original publication in this journal iscited, in accordance with acceptedacademic practice. No use, distribution orreproduction is permitted which does notcomply with these terms.TYPE EditorialPUBLISHED 24 February 2023DOI 10.3389/fendo.2023.1163996Editorial: Parathyroid atypicaladenomas and carcinoma: Anupdate on clinical managementLaura Gianotti 1* and Filomena Cetani21Division of Endocrinology, Department Internal Medicine, S.Croce & Carle Hopsital, Cuneo, Italy,2Unit of Endocrinology, University Hospital of Pisa, Pisa, ItalyKEYWORDSparathyroid carcinoma, atypical adenoma, long non-coding RNAs, CDC73 mutations,ectopic localizationEditorial on the Research TopicParathyroid atypical adenomas and carcinoma: An update onclinical managementAtypical parathyroid adenomas and parathyroid carcinomas are rare amongparathyroid tumors that commonly are benign. They share some histological featuresnamely trabecular growth pattern, fibrous bands, and cellular atypia but parathyroidcarcinoma shows unequivocal features of neoplastic infiltration of adjacent tissues,lympho-vascular invasion, or perineural invasion (1, 2). Atypical parathyroid adenomasrepresent a challenge for the differential diagnosis with parathyroid carcinomas (2).Recently, the new classification of the 2022 WHO Classification of Parathyroid Tumorsno longer endorses the use of “atypical parathyroid adenoma”. This entity has now beenlabeled as “atypical parathyroid tumor” to reflect a parathyroid neoplasm of uncertainmalignant potential (3). The prognosis of patients with parathyroid carcinoma mainlydepends on early detection and a radical surgical treatment. A strict and continued follow-up is mandatory to detect relapse or metastasis (1, 3). The diagnosis of parathyroidcarcinoma is quite difficult due to the lack of reliable clinical diagnostic criteria, and in mostcases is made postoperatively at histological examination (1). The clinical manifestationsare primarily due to the excessive secretion of PTH by the tumor rather than spread to localor distant organs. Over the past few decades there has been no significant trend towarddetecting the disease at an earlier stage, with no significant change in patient survival. Nospecific guidelines addressed to the clinical management of patients with parathyroidcarcinomas are present in literature.The Research Topic on Parathyroid Atypical Adenomas and Carcinoma has givenattention to these aspects and underlines the need of more studies in parathyroid tumorresearch. Accordingly, the interesting application of the bibliometric analysis by a machinelearning-based method in primary hyperparathyroidism (PHPT) proposed by Zhang et al.showed that the annual scientific publications on parathyroid tumors have scarcely changedduring the last two decades. On the other hand, some novel aspects on themolecular profile andgenetics of parathyroid tumours are emerging and new evidence from imaging studies ormedical treatment and surgical techniques have also appeared in recent years. In the Researchtopic an extensive review by Marini et al. summarized the genetic and molecular pathways offrontiersin.org01Gianotti and Cetani 10.3389/fendo.2023.1163996parathyroid carcinogenesis. The Authors focused their attention on thegermline heterozygote inactivating mutations of the CDC73 tumorsuppressor gene that accounts for about 50-75% of familial cases; over75% of sporadic parathyroid carcinomas harbor biallelic somaticinactivation/loss of CDC73 and one-third of them are germline (1).Other novel gene mutations, alterations of the PI3K/AKT/mTORsignaling pathway as well as modifications of microRNA expressionprofile and gene promoter methylation pattern have been detected inparathyroid carcinoma (4).The role of Long non-coding RNAs (lncRNAs) as prognosticand diagnostic biomarkers in parathyroid cancer has also beenexplored by Morotti et al. suggesting that human parathyroidtumors are characterized by a different lncRNAs signature, withthe lncRNA BC200/BCYRN1 representing a candidate biomarkerfor parathyroid carcinoma and its possible use in the post-operativesetting for patient’s follow-up.Clinical aspects and new therapeutical approaches ofparathyroid carcinomas have been extensively revised by Zelanoet al. that reported a life-threatening case of parathyroid carcinoma,associated with several systemic manifestations. Furthermore, someclinical challenge due to ectopic localization of parathyroid tumourshas been raised, as in the paper by Validazeh et al. in whom the firstcase of parathyroid adenoma in the lung has been reported andsuccessfully resected with video-assisted thoracoscopic surgery.In the setting of parathyroid tumors, atypical parathyroidadenomas are considered a distinct clinical entity often associatedwith more severe form of the disease. Accordingly, Bhan et al.presented five cases of PHPT with osteitis fibrosa cystica, anuncommon manifestation of contemporary PHPT associated withlarger parathyroid adenomas. Lastly, it is worth mentioning thecontribute of Tzikos et al. on the evaluation of quality of life (QoL)in patients with PHPT. Through the Pasieka’s parathyroidassessment of symptoms Questionnaire (PAS-Q) and thevalidation of this tool in Greek speaking population, they appliedPAS-Q - a self-administered questionnaire, which was developed inFrontiers in Endocrinology 02Canada specifically to assess the symptoms of PHPT and the impacton patients’ lives. PAS-Q may be considered a useful method toevaluate PHPT patients’ QoL and should be encouraged fordissemination in European and Eastern countries.In conclusion, new aspects are emerging on the pathogenesisand clinical aspects of parathyroid tumors. More attention needs tobe given to the parathyroid disease including molecular and geneticaspects, the disease expression, and the influence on the QoL of thepatients. All these aspects appear to be very important to optimizethe diagnostic workout and individualize the therapeutic strategy ofthe patients.Author contributionsLG and FC equally contributed to conceptualization and writingthe manuscript. All authors contributed to the article and approvedthe submitted version.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that could beconstrued as a potential conflict of interest.Publisher’s noteAll claims expressed in this article are solely those of the authorsand do not necessarily represent those of their affiliatedorganizations, or those of the publisher, the editors and thereviewers. Any product that may be evaluated in this article, orclaim that may be made by its manufacturer, is not guaranteed orendorsed by the publisher.References1. Cetani F, Pardi E, Marcocci C. Parathyroid carcinoma. Front Horm Res (2019)51:63–76. doi: 10.1159/0004910392. Cetani F, Marcocci C, Torregrossa L, Pardi E. Atypical parathyroid adenomas:challenging lesions in the differential diagnosis of endocrine tumors. Endocr RelatCancer (2019) 26(7):R441–64. doi: 10.1530/ERC-19-01353. Erickson LA, Mete O, Juhlin CC, Perren A, Gill AJ. Overview of the 2022 WHOclassification of parathyroid tumors. Endocr Pathol (2022) 33(1):64–89. doi: 10.1007/s12022-022-09709-14. Pandya C, Uzilov AV, Bellizzi J, Lau CY, Moe AS, Strahl M, et al. Genomicprofiling reveals mutational landscape in parathyroid carcinomas. JCI Insight (2017) 2(6):e92061. doi: 10.1172/jci.insight.92061frontiersin.org

Editorial: Parathyroid atypical adenomas and carcinoma: An update on clinical management

https://www.frontiersin.org/articles/10.3389/fendo.2023.1163996/pdf

Editorial: Parathyroid atypical adenomas and carcinoma: An update on clinical management

Abstract

Similar works

Full text

Available Versions

Directory of Open Access Journals