Help the development of the site, sharing the article with friends!

Carcinoma of the parathyroid glands is a very rare malignant neoplasm of the endocrine system. In addition, it is very easy to confuse it with parathyroid adenoma, as well as thyroid cancer, which significantly delays the correct diagnosis. What are the causes and risk factors for developing parathyroid cancer? How to recognize its symptoms? What is the treatment of this type of cancer?

Parathyroid carcinomais a very rarely diagnosed malignant neoplasm of the endocrine system. According to research, it affects from 0.2 to 5 percent. patients with hyperparathyroidism and does not exceed 0.2%. all malignant neoplasms of the endocrine system.

Parathyroid gland cancer , although it belongs to the group of malignant neoplasms, very rarely metastasizes. Unfortunately, it is prone to relapses, which may occur even in half of the treated patients.

Parathyroid cancer - causes and risk factors

The causes of parathyroid cancer are not fully known. In some cases, the disease may have a genetic basis or be associated with hereditary syndromes in which hyperparathyroidism occurs, e.g. with multiple endocrine neoplasia (MEN).

The risk factors for the development of parathyroid carcinoma include radiotherapy of the neck area in the past (especially in childhood or early adolescence), chronic renal failure and all other diseases in the course of which hyperparathyroidism develops, and thus - for the overproduction of PTH.

Parathyroid cancer - symptoms

Parathyroid cancer most often leads to primary hyperparathyroidism (a hormonally inactive tumor is rare). Consequently, its symptoms are related to the overproduction of parathyroid hormone (PTH), a hormone secreted by the parathyroid glands that regulates the levels of calcium and phosphate in the blood. As a result of its increased secretion, hypercalcemia, i.e. an increase in the level of calcium in the blood, occurs at the expense of the calcium accumulated in the bones (which is one of the causes of hypercalcemia), which can lead to osteoporosis and bone fractures.

In addition, there are:

  • digestive system disorders - loss of appetite, increased thirst, abdominal pain, nausea, constipation. Primary hyperparathyroidism can cause diseaseulcers, especially of the duodenum, and pancreatitis;
  • kidney failure, which is caused by calcification (nephrocalcinosis) and a tendency to form stones, which can lead to uremia. Therefore, hyperparathyroidism causes kidney problems and vice versa - renal dysfunction can cause hyperparathyroidism;
  • disorders of the neuromuscular and skeletal systems: muscle weakness, joint pain;
  • mental disorders, initially in the form of irritation or even aggression, followed by blackout.

These symptoms get worse slowly and do not become apparent until the blood calcium level has risen to a significant level.

Important

Parathyroid cancer increases the risk of a hypercalcemic crisis

In the course of parathyroid cancer, there is a high risk of hypercalcemic crisis. This is a condition where the blood calcium levels are significantly elevated or have increased rapidly. A hypercalcemic crisis is a medical emergency and requires immediate medical attention. It is worth knowing that the symptoms of a hypercalcemic crisis are:

  • feeling of weakness increasing
  • severe abdominal pain
  • progressive disturbance of consciousness
  • dehydration (dry mucous membranes, reduced skin elasticity, increased thirst)
  • heart rate acceleration

Parathyroid carcinoma - diagnosis

First, a palpation test is performed, which shows the mass of the tumor on the neck. However, this type of tumor may also indicate parathyroid adenoma and thyroid cancer, so blood and urine tests should be performed subsequently to exclude these and other diseases with a similar course (e.g. primary bone tumors or tumors that metastasize to the bone). diagnosis is confirmed:

  • parathyroid scintigraphy (this involves recording radioactivity above the neck)
  • blood tests - determination of the level of: calcium (increase in concentration above 10.4 mg%), parathyroid hormone (increase in concentration), phosphorus (decrease in concentration), creatinine (for the assessment of kidney function), bone metabolism markers (alkaline phosphatase )
  • urine test: determination of calcium and creatinine levels and markers of bone metabolism (collagen breakdown products)

To assess the effect of the disease on bones, bone mineral density is examined (bone loss is assessed). In turn, to confirm the presence of nephrolithiasis, an ultrasound or X-ray of the kidneys is performed.

Parathyroid cancer - treatment

In the case of parathyroid cancer, the procedure is usedsurgical removal of the tumor along with the entire thyroid lobe. Before the operation, it is very important to obtain normocalcemia (for this purpose, various drugs are used, the most popular of which are bisphosphonates), although this is often not possible.

Radiation therapy may be a complementary treatment, although this method is controversial. Some say it even worsens treatment outcomes. Chemotherapy plays no role in the treatment of this type of cancer. Attempts have been made to use various cytostatics, but without much success.

Help the development of the site, sharing the article with friends!

Category:

Oncology