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Difference between revisions of "Parathyroid carcinoma"
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| Caption = Parathyroid carcinoma. [[H&E stain]]. | | Caption = Parathyroid carcinoma. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = vascular invasion, local invasion, metastases; nuclear atypia ''not'' diagnostic | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = [[parathyroid adenoma]], [[parathyroid hyperplasia]], thyroid lesions | ||
| Stains = | | Stains = | ||
| IHC = [[PAX8]] +ve, Ki-67 >6% +ve | | IHC = [[PAX8]] +ve, Ki-67 >6% +ve, [[GATA3]] +ve, parafibromin -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = +/-HRPT2 gene mutations | ||
| IF = | | IF = | ||
| Gross = | | Gross = | ||
| Line 18: | Line 18: | ||
| Site = [[parathyroid gland]] | | Site = [[parathyroid gland]] | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = familial primary hyperparathyroidism | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = | ||
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==General== | ==General== | ||
*Extremely rare. | *Extremely rare. | ||
*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> | *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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*+/-[[Metastasis]] - '''diagnostic feature'''. | *+/-[[Metastasis]] - '''diagnostic feature'''. | ||
DDx: | |||
* | *[[Parathyroid adenoma]]. | ||
*[[Parathyroid hyperplasia]]. | |||
*[[Poorly differentiated thyroid carcinoma]] and other thyroid cancers. | |||
===Images=== | ===Images=== | ||
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**Parathyroid adenomas and hyperplasias ~ 3%. | **Parathyroid adenomas and hyperplasias ~ 3%. | ||
*[[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> | *[[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> | ||
*GATA3 +ve.<ref>{{cite journal |authors=Ordóñez NG |title=Value of GATA3 immunostaining in the diagnosis of parathyroid tumors |journal=Appl Immunohistochem Mol Morphol |volume=22 |issue=10 |pages=756–61 |date=2014 |pmid=25046229 |doi=10.1097/PAI.0000000000000007 |url=}}</ref> | |||
*Parafibromin -ve.<ref name=pmid15475453>{{cite journal |authors=Tan MH, Morrison C, Wang P, Yang X, Haven CJ, Zhang C, Zhao P, Tretiakova MS, Korpi-Hyovalti E, Burgess JR, Soo KC, Cheah WK, Cao B, Resau J, Morreau H, Teh BT |title=Loss of parafibromin immunoreactivity is a distinguishing feature of parathyroid carcinoma |journal=Clin Cancer Res |volume=10 |issue=19 |pages=6629–37 |date=October 2004 |pmid=15475453 |doi=10.1158/1078-0432.CCR-04-0493 |url=}}</ref> | |||
==Molecular== | |||
*HRPT2 gene mutations (10 of 15 sporadic cases of parathyroid carcinoma).<ref name=pmid14585940>{{cite journal |authors=Shattuck TM, Välimäki S, Obara T, Gaz RD, Clark OH, Shoback D, Wierman ME, Tojo K, Robbins CM, Carpten JD, Farnebo LO, Larsson C, Arnold A |title=Somatic and germ-line mutations of the HRPT2 gene in sporadic parathyroid carcinoma |journal=N Engl J Med |volume=349 |issue=18 |pages=1722–9 |date=October 2003 |pmid=14585940 |doi=10.1056/NEJMoa031237 |url=}}</ref> | |||
Note: | |||
*The HRPT2 gene encodes the parafibromin protein.<ref name=pmid14585940/> | |||
==See also== | ==See also== | ||