Clinicopathological spectrum, management, and outcome of ectopic parathyroid carcinoma: Experience with 24 cases.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2024-07-14 DOI:10.1007/s12020-024-03964-4

Teng Zhao, Jian Huang, Yuting Wang, Dongxue Zhang, Teng Zhang, Ruigang Lu, Hua Gu, Mulan Jin, Hong Shen, Xing Liu, Dalin Feng, Jiacheng Wang, Qian Wang, Bojun Wei

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Abstract

Purpose: Ectopic parathyroid carcinoma (EPC) is a rare clinical entity with multiple diagnostic pitfalls, making surgical cures challenging. We assessed the clinicopathological spectrum and outcome of EPCs.

Methods: In this retrospective cohort study, 24 EPCs were identified from 133 PC patients treated at a tertiary referral center. The relationship between clinicopathological findings and locations was analyzed.

Results: The locations of EPCs were predominantly intrathyroidal (62.5%), followed by 16.7% in the mediastinum, 8.3% in the retropharyngeal space, 8.3% in the carotid sheath, and 4.2% in the upper neck. Intrathyroidal EPC patients experienced higher serum calcium (p = 0.020), a higher rate of vascular invasion (p = 0.040), and a slightly higher incidence of non-R0 initial resection (p = 0.092) than those in other ectopic locations. Intrathyroidal EPC patients also suffered a trend of higher upper aerodigestive tract (UAT) invasion rate (p = 0.070) and higher risks of distant metastasis (p = 0.037) than the other PC patients. The 5-year disease-free survival rate after surgery was slightly compromised at 41.5% in intrathyroidal EPC patients compared with 77.8% among those in other ectopic locations (p = 0.143) and 59.7% among the other PC patients (log-rank = 3.194; p = 0.074), though without statistical significance.

Conclusion: Intrathyroidal EPC might cause a more biochemically and invasively distinct PC picture compared with other PCs. Special caution should be exercised in the preoperative diagnosis and management of such cases.

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异位甲状旁腺癌的临床病理谱、治疗和预后：24 例病例的经验。

目的：异位甲状旁腺癌（EPC）是一种罕见的临床实体，存在多种诊断误区，因此手术治愈具有挑战性。我们评估了EPC的临床病理谱和预后：在这项回顾性队列研究中，从一家三级转诊中心收治的 133 例 PC 患者中发现了 24 例 EPC。分析了临床病理结果与EPC位置之间的关系：结果：EPC的位置主要在甲状腺内（62.5%），其次是纵隔16.7%、咽后间隙8.3%、颈动脉鞘8.3%和颈上部4.2%。与其他异位位置的患者相比，甲状腺内EPC患者的血清钙较高（p = 0.020），血管侵犯率较高（p = 0.040），非R0初始切除率略高（p = 0.092）。与其他PC患者相比，甲状腺内EPC患者的上消化道（UAT）侵犯率（p = 0.070）和远处转移风险（p = 0.037）也呈上升趋势。甲状腺内EPC患者术后5年无病生存率为41.5%，略低于其他异位部位的77.8%（p = 0.143）和其他PC患者的59.7%（log-rank = 3.194; p = 0.074），但无统计学意义：结论：与其他PC相比，甲状旁腺内EPC可能会导致更独特的生化和侵袭性PC。结论：与其他PC相比，甲状腺内EPC可能会导致更独特的生化和侵袭性PC，因此在术前诊断和处理此类病例时应特别谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.

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