%0 Journal Article
%T Clinicopathological spectrum, management, and outcome of ectopic parathyroid carcinoma: Experience with 24 cases.
%A Zhao T
%A Huang J
%A Wang Y
%A Zhang D
%A Zhang T
%A Lu R
%A Gu H
%A Jin M
%A Shen H
%A Liu X
%A Feng D
%A Wang J
%A Wang Q
%A Wei B
%J Endocrine
%V 0
%N 0
%D 2024 Jul 14
%M 39003660
%F 3.925
%R 10.1007/s12020-024-03964-4
%X OBJECTIVE: 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.
CONCLUSIONS: 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.