Localized Parathyroid Cancer
- The initial operation should include an en bloc resection of the tumor that takes care to avoid rupture of the tumor capsule and to ensure that the margins are free of tumor. This procedure will involve a parathyroidectomy, typically an ipsilateral thyroidectomy (thyroid lobectomy), and possibly resection of adjacent cervical muscles, paratracheal tissues, and the recurrent laryngeal nerve, if involved. Lymphadenectomy, beyond that necessary to achieve an en bloc excision of the primary malignancy, is not indicated unless enlarged or firm nodes clinically indicate the presence of nodal disease. Local recurrence may be minimized by this en bloc resection approach. Preoperative medical management to lower elevated calcium levels and to correct other metabolic disturbances that are due to hyperparathyroidism is critical.
- Surgery followed by radiation therapy.[4,5,6]
- Radiation therapy.
Current Clinical Trials
General Information The natural history of disease in adult Langerhans cell histiocytosis (LCH), with the exception of pulmonary LCH, is unknown. It is unclear whether there are significant differences from childhood LCH, although it appears that multisystem-risk LCH is less aggressive than childhood high-risk disease. The risk of reactivations is unknown. Incidence It is estimated that one to two adult cases of LCH occur per million population.[1] The true incidence of this disease...
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Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized parathyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
References:
- Fraker DL: Parathyroid Tumors. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005, pp 1521-27.
- Sandelin K, Auer G, Bondeson L, et al.: Prognostic factors in parathyroid cancer: a review of 95 cases. World J Surg 16 (4): 724-31, 1992 Jul-Aug.
- Koea JB, Shaw JH: Parathyroid cancer: biology and management. Surg Oncol 8 (3): 155-65, 1999.
- Clayman GL, Gonzalez HE, El-Naggar A, et al.: Parathyroid carcinoma: evaluation and interdisciplinary management. Cancer 100 (5): 900-5, 2004.
- Munson ND, Foote RL, Northcutt RC, et al.: Parathyroid carcinoma: is there a role for adjuvant radiation therapy? Cancer 98 (11): 2378-84, 2003.
- Chow E, Tsang RW, Brierley JD, et al.: Parathyroid carcinoma--the Princess Margaret Hospital experience. Int J Radiat Oncol Biol Phys 41 (3): 569-72, 1998.
WebMD Public Information from the National Cancer Institute
