Cohn K, Silverman M, Corrado J, Sedgewick C
Surgery. 1985 Dec;98(6):1095-100.
From 1942 to 1984, 301 operations were performed for hyperparathyroidism; nine patients (3%) had carcinoma. The mean serum calcium level of the patients with carcinoma was 14.0 mg/dl, whereas the mean serum calcium level of patients with benign hyperparathyroidism was 12.0 mg/dl. With follow-up ranging from 2 to 16 years, there has been one death 9 years after the initial operation caused by primary lung cancer. At autopsy the patient also had a recurrence of parathyroid carcinoma in the neck. There were no additional recurrences or deaths. Prognosis was not correlated with any laboratory or pathologic findings. The importance of intraoperative recognition at the time of the initial operation is stressed. En bloc resection is recommended, including ipsilateral thyroid lobectomy and dissection of the tracheoesophageal groove. Radical neck dissection is performed only for extensive cervical node metastases or for reoperations where scarring prevents accurate delineation of the extent of the tumor.
1942年至1984年期间，共对甲状旁腺功能亢进症患者实施了301例手术；其中9例（3%）为甲状旁腺癌。甲状旁腺癌患者的血清钙平均水平为14.0mg/dl，而良性甲状旁腺功能亢进症患者的血清钙平均水平为12.0mg/dl。随访时间为2至16年，1例患者在初次手术后9年因原发性肺癌死亡。尸检时发现该患者颈部甲状旁腺癌复发。未出现其他复发或死亡病例。预后与任何实验室或病理检查结果均无关联。强调了初次手术时术中识别的重要性。建议整块切除，包括同侧甲状腺叶切除及气管食管沟清扫。仅在广泛的颈部淋巴结转移或再次手术因瘢痕形成无法准确界定肿瘤范围时才进行根治性颈清扫术。
