Favia G, Lumachi F, Polistina F, D'Amico D F
Endocrine Surgery Unit, University of Padova, Italy.
World J Surg. 1998 Dec;22(12):1225-30. doi: 10.1007/s002689900549.
We undertook a retrospective study in 16 patients with parathyroid carcinoma, with the aim of conveying experience from management of this rare cause of hyperparathyroidism (HPT). From 1980 to 1996 we operated on 309 patients with HPT, 290 of whom had primary HPT, and parathyroid carcinoma was diagnosed in 16 (5.2%) cases. In none was the malignancy diagnosed preoperatively. The average serum calcium and parathyroid hormone levels were significantly higher (p < 0.05) than in patients with parathyroid adenoma, and the mean tumor size was 2.9 cm (median 2.5 cm, range 1.5-4.5 cm). Twenty-eight operations were performed with resulting normalization of serum calcium levels for more than 6 months in 11 patients. Six patients presented prolonged postoperative hypocalcemia (2-10 months), and five patients had persistent HPT. Ten patients experienced recurrent disease; the median disease-free period was 24 months (range 4-72 months). None of the patients was treated with chemotherapy, one patient underwent radiation therapy (50 Gy in 25 sessions) but required reoperation for local recurrence 4 months later. Three patients are still alive (two with recurrence). Average survival was 40 months (median 31 months, range 11-131 months).
我们对16例甲状旁腺癌患者进行了一项回顾性研究，目的是分享这种罕见的甲状旁腺功能亢进症（HPT）病因的治疗经验。1980年至1996年期间，我们对309例HPT患者进行了手术，其中290例为原发性HPT，16例（5.2%）被诊断为甲状旁腺癌。术前均未诊断出恶性肿瘤。甲状旁腺癌患者的平均血清钙和甲状旁腺激素水平显著高于甲状旁腺腺瘤患者（p<0.05），平均肿瘤大小为2.9 cm（中位数2.5 cm，范围1.5 - 4.5 cm）。共进行了28次手术，11例患者术后血清钙水平正常化超过6个月。6例患者术后出现长期低钙血症（2 - 10个月），5例患者甲状旁腺功能亢进持续存在。10例患者疾病复发；无病生存期的中位数为24个月（范围4 - 72个月）。所有患者均未接受化疗，1例患者接受了放射治疗（25次，共50 Gy），但4个月后因局部复发需要再次手术。3例患者仍然存活（2例复发）。平均生存期为40个月（中位数31个月，范围11 - 131个月）。
