Parathyroid Carcinoma: A Single-Institution Experience with an Emphasis on Histopathological Features
- PDF / 1,407,381 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 58 Downloads / 174 Views
ORIGINAL PAPER
Parathyroid Carcinoma: A Single‑Institution Experience with an Emphasis on Histopathological Features Akash Pramod Sali1,2 · Priyal Motghare1,3 · Munita Bal1 · Neha Mittal1 · Swapnil Rane1 · Shubhada Kane1 · Asawari Patil1 Received: 4 August 2020 / Accepted: 22 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Parathyroid carcinoma (PC) is a rare malignancy that poses a diagnostic challenge on histologic examination. We analyzed various clinicopathologic features of PC. Pathology reports and slides were reviewed to evaluate the diagnostic histopathologic features of archived cases of PC from the years of 2004–2018. The study cohort comprised twenty cases of PC. The median age was 49 years (range 21–73 years) with equal gender distribution (M:F = 1:1). Most patients presented with symptoms of hypercalcemia (n = 7, 54%). Serum calcium and serum parathyroid hormone were elevated in all but one patient. The right inferior parathyroid was commonly involved (n = 8/14, 57%). The mean tumor size was 2.4 cm (range 0.8–3.5 cm). On frozen section examination, PC was diagnosed in 8 out of 9 cases. Vascular (n = 19/20, 95%) and soft tissue invasion (n = 10/20, 50%) were the most common characteristic histologic findings. Capsular invasion was identified in all cases. Perineural invasion or metastasis at presentation was absent in all cases. Other histological features noted were intratumoral fibrous bands (70%), nodular growth pattern (70%), moderate nuclear atypia (30%), prominent nucleoli (20%), and necrosis (20%). Regional lymph nodes were negative for metastatic disease in all cases (n = 10). Eight out of 16 patients received adjuvant radiotherapy. Follow-up was available in 16 cases (median 21.5 months). Two patients died of disease. Vascular and soft tissue invasion are the most common diagnostic histologic features of PC. Capsular invasion is important to distinguish PC from its benign counterparts. Intraoperative frozen section examination can be used for accurate diagnosis and surgical management. Keywords Parathyroid carcinoma · Histopathology · Diagnostic criteria · Vascular invasion · Soft tissue invasion · Capsular invasion
Introduction Synopsis Vascular and soft tissue invasion are the most frequent features used to diagnose parathyroid carcinoma; capsular invasion being an important indicator. The frozen section can clinch an accurate diagnosis. * Asawari Patil [email protected] 1
Department of Pathology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, 8th Floor, Annexe Building, Dr. E. Borges Road, Parel, Mumbai 400012, India
2
Department of Pathology, Homi Bhabha Cancer Hospital (A Unit of Tata Memorial Centre), Sangrur, Punjab 148001, India
3
Department of Pathology, SRL Diagnostic Lab, Fortis Hospital, Mumbai 400078, India
The spectrum of parathyroid lesions comprises parathyroid hyperplasia, parathyroid adenoma (PA), and the rare parathyroid carcinoma (PC). It is challenging to differentiate PC fro
Data Loading...
