Document Detail


Indian primary hyperparathyroidism patients with parathyroid carcinoma do not differ in clinicoinvestigative characteristics from those with benign parathyroid pathology.
MedLine Citation:
PMID:  16680588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: No foolproof preoperative diagnostic indicators of parathyroid carcinoma (PC) exist in absence of nonskeletal metastases. Palpable parathyroid tumor, advanced skeletal and renal manifestations, and very high serum calcium and parathyroid hormone levels are considered strong predictors. Most of these features are common in Indian primary hyperparathyroidism (PHPT) patients although only few have PC. The aim of this study was to identify dependable clinicoinvestigative predictors of PC in Indian PHPT patients. MATERIALS AND METHODS: Clinical, biochemical, radiological, and densitometric attributes of 100 PHPT patients who underwent successful parathyroidectomy (1990-2004) were studied. Various parameters of patient groups with parathyroid adenoma (n = 84), primary hyperplasia (n = 12), and carcinoma (n = 4) were compared using ANOVA, with P value < 0.05 considered significant. RESULTS: Mean age of patients was 37.4 years, with no difference in the 3 groups (P = 0.92). Patients in 3 groups had comparably severe bone disease; 36 had coexistent renal disease. Two patients with PC and 27 (32%) with adenoma had palpable parathyroid tumor. None of the biochemical parameters predicted malignant pathology. Mean tumor weight (milligram) in carcinoma patients (15,080 +/- 5,638.02) was significantly higher than those with adenoma (5,724 +/- 1,257.9) (P = 0.002). Postoperative course and recovery in carcinoma patients were similar to those with adenoma. In follow-up (mean: 33 months), none of the adenoma patients were found to have persistent/recurrent PHPT attributable to missed PC. CONCLUSION: Indian patients with parathyroid adenoma, hyperplasia, and carcinoma were not found to differ in their clinical, biochemical, and pathological characteristics except for significantly higher tumor weight in the carcinoma group.
Authors:
Gaurav Agarwal; Kaushal K Prasad; Dilip K Kar; Narendra Krishnani; Rakesh Pandey; Saroj K Mishra
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  30     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-08     Completed Date:  2006-10-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  732-42     Citation Subset:  IM    
Affiliation:
Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India. gaurav@sgpgi.ac.in
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MeSH Terms
Descriptor/Qualifier:
Adenoma / diagnosis*
Adolescent
Adult
Aged
Carcinoma / diagnosis*
Female
Humans
Hyperparathyroidism, Primary / etiology*
Hyperplasia / diagnosis
India
Male
Middle Aged
Parathyroid Diseases / diagnosis
Parathyroid Neoplasms / diagnosis*
Predictive Value of Tests

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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