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Metastatic Parathyroid Cancer
Metastatic disease can appear shortly after the initial diagnosis and operation or for up to 20 years later.[1] Because of the difficulty in making a histologic diagnosis, the appearance of recurrent or metastatic disease in a patient previously operated on for hypercalcemia can be the first indicator that the tumor was malignant.[2] Approximately 50% of the patients who experience recurrence will have distant metastases.[3] The most common site of distant metastasis is the lung.[4,5] Some patients experience years of survival even after the diagnosis of distant metastases.[5] Aggressive surgical resection has been associated with a 30% long-term survival in retrospective series.[3,6] (Refer to the PDQ summary on Hypercalcemia for more information.)
TREATMENT OPTIONS: [1] [3] [4] [5] [6] [7] [8] [9] [10]
- Metastasectomy: Because parathyroid carcinoma can be slow growing, resection of distant metastases can be effective for palliation and occasional cure.
- Medical management of hypercalcemia.[5,10,11,12]
- Surgery plus radiation therapy.
- Radiation therapy.
- Chemotherapy. Anecdotal reports show that short-term remissions with chemotherapy are possible.[5,10]
Current Clinical Trials
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with metastatic 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:
- Wynne AG, van Heerden J, Carney JA, et al.: Parathyroid carcinoma: clinical and pathologic features in 43 patients. Medicine (Baltimore) 71 (4): 197-205, 1992.
- Busaidy NL, Jimenez C, Habra MA, et al.: Parathyroid carcinoma: a 22-year experience. Head Neck 26 (8): 716-26, 2004.
- Sandelin K, Tullgren O, Farnebo LO: Clinical course of metastatic parathyroid cancer. World J Surg 18 (4): 594-8; discussion 599, 1994 Jul-Aug.
- Favia G, Lumachi F, Polistina F, et al.: Parathyroid carcinoma: sixteen new cases and suggestions for correct management. World J Surg 22 (12): 1225-30, 1998.
- Shane E: Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab 86 (2): 485-93, 2001.
- Obara T, Okamoto T, Ito Y, et al.: Surgical and medical management of patients with pulmonary metastasis from parathyroid carcinoma. Surgery 114 (6): 1040-8; discussion 1048-9, 1993.
- Vetto JT, Brennan MF, Woodruf J, et al.: Parathyroid carcinoma: diagnosis and clinical history. Surgery 114 (5): 882-92, 1993.
- Sandelin K: Parathyroid carcinoma. Cancer Treat Res 89: 183-92, 1997.
- Iacobone M, Lumachi F, Favia G: Up-to-date on parathyroid carcinoma: analysis of an experience of 19 cases. J Surg Oncol 88 (4): 223-8, 2004.
- 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.
- Clayman GL, Gonzalez HE, El-Naggar A, et al.: Parathyroid carcinoma: evaluation and interdisciplinary management. Cancer 100 (5): 900-5, 2004.
- Peacock M, Bilezikian JP, Klassen PS, et al.: Cinacalcet hydrochloride maintains long-term normocalcemia in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 90 (1): 135-41, 2005.
WebMD Public Information from the National Cancer Institute
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER
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