Puesta al día: Carcinoma paratiroideo
Date
2021Author
Silva-Figueroa, Angelica
Barberan, Marcela
Campusano, Claudia
Salman, Patricio
Trejo, Pamela
Rivera, Sandra
Florenzano, Pablo
Velasco, Soledad
Illanes, Francisca
Trincado, Patricio
Canessa, José
Solar, Antonieta
Marcela, Moreno
Eugenin, Daniela
Jiménez, Beatriz
Arroyo, Patricia
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Abstract
Parathyroid carcinoma is a rare malignant disease that presents as a
sporadic or familial primary hyperparathyroidism (PHP). The latter is
associated with some genetic syndromes. It occurs with equal frequency
in both sexes, unlike PHP caused by parathyroid adenoma that is more
common in women. It should be suspected in cases of severe hypercalcemia, with high parathyroid hormone levels and a palpable cervical mass.
Given the difficulty in distinguishing between parathyroid carcinoma
and adenoma prior to the surgery, the diagnosis is often made after
parathyroidectomy. The only curative treatment is complete surgical resection with oncologic block resection of the primary tumor to ensure free
margins. Adjuvant therapies with chemotherapy or radiation therapy
do not modify overall or disease-free survival. Recurrences are common
and re-operation of resectable recurrent disease is recommended. The
palliative treatment of symptomatic hypercalcemia is crucial in persistent
or recurrent disease after surgery since morbidity and mortality are more
associated with hypercalcemia than with tumor burden.