J.Jpn. Surg. Soc.. 81(4): 291-298, 1980

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Original article

CLINICO-PATHOLOGICAL STUDIES ON PARATHYROID CARCINOMA

With an increasing incidence of the primary hyperparathyroidism mainly due to the widely available serum calcium measurement, the understanding and proper surgical treatment of parathyroid carcinoma has become one of the important items of general surgery. During the 12 year period since 1968 we have experienced 100 cases of surgically treated primary hyperparathyroidism. Of those 6 were parathyroid carcinoma and they were analized from the surgical and pathological standpoints. The folloling results were obtained:
I. Detection of parathyroid carcinoma in its early stage has become available by the use of autoanalizer for the routine measurement of serum calcium for both out-patients and hospitalized patients.
2. The clinical symptoms of parathyroid carcinoma are variable, from the asymptomatic patients to the severe hypercalcemic crisis.
3. Occasionally an emergency operation may be necessary, when the marked hypercalcemic state is difficult to control by the extensive nonsurgical treatment.
4. At operation, the surgeons should be alert to recognize any pathologic change suggestive of parathyroid carcinoma. Careful en block excision with removal of any adjacent or surrounding structures is most important for primary treatment.
5. Histologically the parathyroid carcinoma is characterized by a thick fibrous capsule and trabecula formation, and a solid or trabecular arrangement of tumor cells. The invasion into the capsule and the blood vessels, and the presence of mitotic figures are the definitive criteria for the diagnosis of parathyroid carcinoma.
6. All the 6 patients are living well, although reoperation was necessary in 3 of them.

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