Atypical parathyroid tumor: clinical and parathyroid hormone response to surgical treatment

Antonio Giulio Napolitano; Massimo Monacelli; Valeria Liparulo; Eleonora Coviello; Domenico Pourmolkara; Stefano Avenia; Andrea Polistena

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저자정보: Antonio Giulio Napolitano (University of Perugia Medical School) Massimo Monacelli (University of Perugia Medical School) Valeria Liparulo (University of Perugia Medical School) Eleonora Coviello (University of Perugia Medical School) Domenico Pourmolkara (University of Perugia Medical School) Stefano Avenia (University of Perugia Medical School) Andrea Polistena (Sapienza University of Rome)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.105 No.2

발행연도: 2023.8

수록면: 76 - 81 (6page)

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Purpose: Primary hyperparathyroidism (PHPT) is caused by typical adenoma (TA), multiglandular disease (MD), or parathyroid carcinoma (PC), and in a smaller percentage of cases by atypical parathyroid tumor (APT). The objective of this study is the retrospective analysis of clinical features and parathyroid hormone (PTH)/calcium response to surgery in patients who underwent parathyroidectomy for symptomatic PHPT with histological evidence of APT.
Methods: We retrospectively reviewed our institutional experience in the management of PHPT from January 2016 to December 2021 focusing on those patients presenting APTs. We analyzed the clinical features of this disease and PTH/calcium response to surgical treatment in APTs compared to the other pathological conditions causing PHPT.
Results: In a cohort of 125 patients with PHPT we found 112 TAs (89.6%), 6 APTs (4.8%), 6 PCs (4.8%), and only 1 MD (0.8%). APTs in comparison to other parathyroid diseases showed peculiar features such as adhesion to the surrounding structures and a frequent intrathyroidal location, which may justify thyroid loboistmectomy adopted in most of the observed cases. APTs showed significantly higher preoperative PTH values compared to TA + MD and were relevant to PC.
Conclusion: Due to its rarity, there is a lack of specific indications in the management of APTs. Biochemical features observed in APT and PC can be related to similar biological behavior. However, some specific features observed preoperatively in some cases of PHPT might suggest presence of an APT, which could be helpful mostly in surgical and postoperative management. Further studies are required to confirm the results of the present preliminary report.

#Atypical parathyroid tumor #Loboistmectomy #Parathyroidectomy #Parathyroid hormone #Primary hyperparathyroidism

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