Difference between revisions of "Parathyroid carcinoma"

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{{ Infobox diagnosis
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| Name      = {{PAGENAME}}
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| Image      = Parathyroid carcinoma - 1 -- high mag.jpg
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| Width      =
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| Caption    = Parathyroid carcinoma. [[H&E stain]].
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| Synonyms  =
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| Micro      =
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| Subtypes  =
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| LMDDx      =
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| Stains    =
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| IHC        = [[PAX8]] +ve, Ki-67 >6% +ve
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| EM        =
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| Molecular  =
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| IF        =
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| Gross      =
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| Grossing  =
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| Staging    =
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| Site      = [[parathyroid gland]]
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| Assdx      =
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| Syndromes  = familial primary hyperparathyroidism
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| Clinicalhx =
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| Signs      =
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| Symptoms  =
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| Prevalence = very rare
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| Bloodwork  =
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| Rads      =
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| Endoscopy  =
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| Prognosis  = poor
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| Other      =
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| ClinDDx    = [[parathyroid adenoma]], [[parathyroid hyperplasia]], [[thyroid cancer]]
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| Tx        = surgical excision
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}}
 
'''Parathyroid carcinoma''' is a rare epithelial malignancy of the [[parathyroid gland]].
 
'''Parathyroid carcinoma''' is a rare epithelial malignancy of the [[parathyroid gland]].
  
 
==General==
 
==General==
 
*Extremely rare.
 
*Extremely rare.
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*May be seen in the context of ''familial primary hyperparathyroidism'' (PHPT).<ref name=pmid28949121>{{Cite journal  | last1 = Cetani | first1 = F. | last2 = Pardi | first2 = E. | last3 = Marcocci | first3 = C. | title = Parathyroid carcinoma: a clinical and genetic perspective. | journal = Minerva Endocrinol | volume = 43 | issue = 2 | pages = 144-155 | month = Jun | year = 2018 | doi = 10.23736/S0391-1977.17.02737-7 | PMID = 28949121 }}</ref>
  
 
==Microscopic==
 
==Microscopic==
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*Ki-67 >6% of cells positive - supports diagnosis.<ref name=pmid7860042>{{Cite journal  | last1 = Abbona | first1 = GC. | last2 = Papotti | first2 = M. | last3 = Gasparri | first3 = G. | last4 = Bussolati | first4 = G. | title = Proliferative activity in parathyroid tumors as detected by Ki-67 immunostaining. | journal = Hum Pathol | volume = 26 | issue = 2 | pages = 135-8 | month = Feb | year = 1995 | doi =  | PMID = 7860042 }}</ref>
 
*Ki-67 >6% of cells positive - supports diagnosis.<ref name=pmid7860042>{{Cite journal  | last1 = Abbona | first1 = GC. | last2 = Papotti | first2 = M. | last3 = Gasparri | first3 = G. | last4 = Bussolati | first4 = G. | title = Proliferative activity in parathyroid tumors as detected by Ki-67 immunostaining. | journal = Hum Pathol | volume = 26 | issue = 2 | pages = 135-8 | month = Feb | year = 1995 | doi =  | PMID = 7860042 }}</ref>
 
**Parathyroid adenomas and hyperplasias ~ 3%.
 
**Parathyroid adenomas and hyperplasias ~ 3%.
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*[[PAX8]] +ve.<ref name=pmid22498579>{{Cite journal  | last1 = Ordóñez | first1 = NG. | title = Value of PAX 8 immunostaining in tumor diagnosis: a review and update. | journal = Adv Anat Pathol | volume = 19 | issue = 3 | pages = 140-51 | month = May | year = 2012 | doi = 10.1097/PAP.0b013e318253465d | PMID = 22498579 }}</ref>
  
 
==See also==
 
==See also==

Revision as of 00:08, 11 June 2019

Parathyroid carcinoma
Diagnosis in short

Parathyroid carcinoma. H&E stain.
IHC PAX8 +ve, Ki-67 >6% +ve
Site parathyroid gland

Syndromes familial primary hyperparathyroidism

Prevalence very rare
Prognosis poor
Clin. DDx parathyroid adenoma, parathyroid hyperplasia, thyroid cancer
Treatment surgical excision

Parathyroid carcinoma is a rare epithelial malignancy of the parathyroid gland.

General

  • Extremely rare.
  • May be seen in the context of familial primary hyperparathyroidism (PHPT).[1]

Microscopic

Features:[2]

  • Histologically normal parathyroid cells.
    • Cytologic features not reliable for diagnosis.
  • Fibrous capsule.
  • Invasion of surrounding tissue - key feature.
  • +/-Metastasis - diagnostic feature.

Note:

  • Diagnosis of parathyroid carcinoma is like that of malignant pheochromocytoma - cytology useless, tissue invasion and metastases are the key features.

Images

IHC

  • Ki-67 >6% of cells positive - supports diagnosis.[3]
    • Parathyroid adenomas and hyperplasias ~ 3%.
  • PAX8 +ve.[4]

See also

References

  1. Cetani, F.; Pardi, E.; Marcocci, C. (Jun 2018). "Parathyroid carcinoma: a clinical and genetic perspective.". Minerva Endocrinol 43 (2): 144-155. doi:10.23736/S0391-1977.17.02737-7. PMID 28949121.
  2. Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1128. ISBN 978-1416031215.
  3. Abbona, GC.; Papotti, M.; Gasparri, G.; Bussolati, G. (Feb 1995). "Proliferative activity in parathyroid tumors as detected by Ki-67 immunostaining.". Hum Pathol 26 (2): 135-8. PMID 7860042.
  4. Ordóñez, NG. (May 2012). "Value of PAX 8 immunostaining in tumor diagnosis: a review and update.". Adv Anat Pathol 19 (3): 140-51. doi:10.1097/PAP.0b013e318253465d. PMID 22498579.