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2011, Number 3

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Rev Endocrinol Nutr 2011; 19 (3)

Clinical, biochemical and histopathological features in parathyroid carcinoma of Hospital de Especialidades Centro Médico Nacional Siglo XXI

Flores-Sánchez EG, Mendoza-Zubieta V, Ramírez-Rentería C, González-Villaseñor GA, Mercado M

Language: Spanish
References: 33
Page: 106-112
PDF size: 79.62 Kb.


ABSTRACT

Background: Parathyroid carcinoma is rare cause of hyperparathyroidism. The rarity of parathyroid carcinoma (PC) makes it easily confused with primary hyperparathyroidism (HPP), despite clinical and biochemical characteristics. There are no defined criteria for diagnosis. Its definitive treatment is surgical by an experienced surgeon. Objective: To compare clinical, biochemical and histopathological features between HPP and CP in this series of patients. Methods: Retrospective cross-sectional, comparative study, of the last five years in the endocrinology department. We analyzed levels of calcium, phosphorus, parathyroid hormone (PTH), renal function, bone densitometry and histopathology. Patients were classified into two groups: benign HPP and CP. χ2 test, Student’s t and Wilcoxon were used. Results: Of 218 patients with HPP CP prevalence was 4%. Benign HPP causes were: adenoma (75%), hyperplasia (18%) and double adenoma (2%). Inferior parathyroid glands were afected in 53% of CP. CP was similar in men and women (p = 0.022), mean serum calcium was 11.4 mg/dL HPP (9.0-21.2) and 14.2 mg/dL (12.5-16.0) in CP, p ‹ 0.001, average PTH in HPP was 183.5 pg/mL (33.4-4,647) and 940 pg/mL in CP (410-1,214) p ‹ 0.001; tumor size was 2.0 cm (0.3- 6.0) in HPP and 4.0 cm (3.0 -5.0) p ‹ 0.001 in CP, palpable tumor was 14.3% of HPP and 100% in CP; and creatinine 0.90 mg/dL (0.50-2.31) in HPP and 1.65 mg/dL (0.40-3.46) in CP, p ‹ 0012. All patients had a minimum follow up of five years. The cure rate was 62% at five years. Conclusion: The prevalence of CP was 4%, where there is a higher frequency of palpable tumor, bone disease, renal, marked hypercalcemia, elevated PTH levels and more severe complications.


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