Iacobone Maurizio, Ruffolo Cesare, Lumachi Franco, Favia Gennaro
Endocrine Surgery Unit, Department of Surgical and Gastroenterological Sciences, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy.
Langenbecks Arch Surg. 2005 Sep;390(5):385-90. doi: 10.1007/s00423-005-0555-6. Epub 2005 Jun 3.
Parathyroid carcinoma (PC) is a rare cause of primary hyperparathyroidism. Surgery is the only effective treatment; re-operations are often required, because recurrences occur in most of the cases. The aim of this retrospective study was to analyse the rate of biochemical cure, clinical relief, sensitivity of localizing studies and morbidity after re-operations.
From January 1980 to December 2000, 19 patients underwent surgery for PC. PC persisted or recurred in all cases. Fourteen re-operations were performed in six patients.
Twelve re-operations at loco-regional site and two pulmonary metastasectomies were performed. Iterative surgery achieved a symptomatic relief in 86% of cases and a transient biochemical remission only in one patient, but significantly reduced parathormone and calcemia. The sensitivity of scintigraphy, CT and ultrasonography was 86, 79 and 100%, respectively.
When recurrences occur, complete cure of PC is unlikely, despite re-operations. Iterative surgery is associated with some morbidity and never achieves a definitive cure, but provides significant clinical and biochemical palliation. Localizing studies are mandatory but do not detect all recurrences.
甲状旁腺癌（PC）是原发性甲状旁腺功能亢进症的罕见病因。手术是唯一有效的治疗方法；由于大多数病例会复发，因此常常需要再次手术。这项回顾性研究的目的是分析再次手术后的生化治愈、临床缓解、定位检查的敏感性和发病率。
1980年1月至2000年12月，19例患者接受了甲状旁腺癌手术。所有病例中甲状旁腺癌均持续存在或复发。6例患者进行了14次再次手术。
进行了12次局部区域再次手术和2次肺转移瘤切除术。反复手术在86%的病例中实现了症状缓解，仅1例患者实现了短暂的生化缓解，但显著降低了甲状旁腺激素和血钙水平。闪烁扫描、CT和超声检查的敏感性分别为86%、79%和100%。
复发时，尽管进行了再次手术，甲状旁腺癌也不太可能完全治愈。反复手术会带来一些发病率，且从未实现根治，但能提供显著的临床和生化缓解。定位检查是必要的，但无法检测到所有复发情况。
