Parathyroid carcinoma: Three case reports

Abstract

BACKGROUND

Parathyroid carcinoma (PC) is a rare, slow-growing malignant tumor and a rare cause of primary hyperfunctioning of the parathyroid, with a highly variable clinical course, depending on the aggressiveness of the individual tumor and the degree of hypercalcemia.

CASE SUMMARY

The aim of this report is to summarize the diagnosis and treatment of three cases of PC and to review and conclude aspects regarding the three collected cases with reference to other relevant cases to explore the value of ultrasound in the diagnosis of PC. All three patients had hypercalcemia, consisting of a high serum calcium level and a high level of parathyroid hormone that was > 2-fold (even > 30-fold) of the normal upper limit. The ultrasonographic findings of the parathyroid gland showed that the glands were all > 30 mm, and the internal echo was uneven. All patients underwent surgery. PC in three cases was confirmed by routine histopathology and immunohistochemistry.

CONCLUSION

As clinical signs and laboratory results are nonspecific, it is difficult to diagnose PC preoperatively, so imaging examinations are often needed.

Keywords: Parathyroid carcinoma; Parathyroid adenoma; Ultrasound; Parathyroid hormone; Primary parathyroid hyperfunction; Case report

Core tip: Parathyroid carcinoma (PC) is a rare malignant tumor with a highly variable clinical course, depending on the aggressiveness of the individual tumor and the degree of hypercalcemia. As clinical signs and laboratory results are nonspecific, it is difficult to diagnose PC before surgery, so relevant imaging examinations are often needed. The aim of this report is to summarize the diagnosis and treatment of three cases of PC and to review and conclude aspects regarding the three collected cases with reference to other relevant cases to explore the value of ultrasound in the diagnosis of PC.