Metastatic Parathyroid Cancer
Metastatic disease can appear shortly after the initial diagnosis and operation or for up to 20 years later. 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. Approximately 50% of the patients who experience recurrence will have distant metastases. 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. 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.)
- Metastasectomy: Because parathyroid carcinoma can be slow growing, resection of distant metastases can be effective for palliation and occasional cure.
- Medical management of hypercalcemia.[5,10-12]
- Surgery plus radiation therapy.
- Radiation therapy.
- Chemotherapy. Anecdotal reports show that short-term remissions with chemotherapy are possible.[5,10]
Check for U.S. clinical trials from NCI's list of cancer clinical trials 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
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- Busaidy NL, Jimenez C, Habra MA, et al.: Parathyroid carcinoma: a 22-year experience. Head Neck 26 (8): 716-26, 2004. [PUBMED Abstract]
- Sandelin K, Tullgren O, Farnebo LO: Clinical course of metastatic parathyroid cancer. World J Surg 18 (4): 594-8; discussion 599, 1994 Jul-Aug. [PUBMED Abstract]
- 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. [PUBMED Abstract]
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- 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. [PUBMED Abstract]
- Vetto JT, Brennan MF, Woodruf J, et al.: Parathyroid carcinoma: diagnosis and clinical history. Surgery 114 (5): 882-92, 1993. [PUBMED Abstract]
- Sandelin K: Parathyroid carcinoma. Cancer Treat Res 89: 183-92, 1997. [PUBMED Abstract]
- 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. [PUBMED Abstract]
- Rahbari R, Kebebew E: Parathyroid tumors. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1473-9.
- Clayman GL, Gonzalez HE, El-Naggar A, et al.: Parathyroid carcinoma: evaluation and interdisciplinary management. Cancer 100 (5): 900-5, 2004. [PUBMED Abstract]
- 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. [PUBMED Abstract]