Analysis of clinicopathological of parathyroid carcinoma in 28 cases

FANG Haisheng; HUA Hongjin; LI Kedong; SHEN Meiping; SI Yan

doi:10.3969/j.issn.1674-4136.2025.05.012

Abstract：Objective To investigate the clinical and pathological features and key points for differential diagnosis of parathyroid carcinoma.Methods A retrospective review was conducted on the clinical and pathological data of 28 cases of parathyroid carcinoma from January 2007 to February 2024 in the Pathology Department of Jiangsu Province Hospital.The relevant pathological slides were re-examined and analyzed.Results Of the 28 parathyroid carcinoma patients,12 were male and 16 were female,with an average age of 52.4±11.6 years.The average tumor size was 28.07±9.42 mm,and there was a significant elevation in preoperative serum calcium levels and parathyroid hormone(PTH)values.Microscopically,the tumors exhibited an invasive growth pattern.In 22 cases,tumor infiltration into the surrounding tissues was observed,and intravascular tumor thrombi were present in 15 cases.Histologically,the tumors were arranged in a sheet,nest,or trabecular pattern,with cells that were round,with clear or eosinophilic cytoplasm.The majority of cells showed mild to moderate atypia,with slightly enlarged nuclei that were round or oval,surrounded by a perinuclear halo,fine chromatin,and visible nucleoli.In cases of multiple recurrences,there was an increase in cellular atypia,with bizarre nuclei and increased mitotic figures,and tumor necrosis was observed in some cases.Conclusions Parathyroid carcinoma is a rare malignancy that poses challenges for accurate preoperative and intraoperative diagnosis.When the tumor boundaries with surrounding tissues are indistinct during surgery,it is imperative to excise the parathyroid gland along with the adherent tissues for pathological examination to establish a definitive diagnosis.