Parathyroid carcinoma in primary hyperparathyroidism: single institution experience

Background Parathyroid carcinoma as a cause of primary hyperparathyroidism is very rare. Clear consensus regarding the optimal management of patients with this condition is not available. We aimed to report our experience with this entity. Methods We analyzed medical records of patients who were operated for primary hyperparathyroidism and parathyroid carcinoma in the Centre for Endocrine Surgery in Belgrade, between January 2000 and December 2007. Results Seven patients (four men and three women) were operated for parathyroid carcinoma and primary HPT in our institution in this period. The age at initial diagnosis (mean +/- SD) was 53.5 +/- 7.6 years. All patients had hypercalcemia (mean 3.53 mmol/l) and very elevated parathyroid hormone (mean 1,530 pg/ml). Extirpation of the parathyroid tumor was performed in two patients, while in five patients parathyroidectomy was performed en block with all involved tissue. Average follow up was 47 months. One patient died for another disease, one was found to have increased calcium and parathyroid hormone levels postoperatively, while the remaining five were free of disease. Conclusions Surgery remains central in the management of patients with parathyroid carcinoma. Still, further multicentric studies should be performed for consistent treatment guidelines.