Justin B Rufener1, James I Cohen. 1. Department of Otolaryngology/Head and Neck Surgery PV-01, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
Abstract
BACKGROUND: Parathyroid carcinoma is rare and accounts for approximately 1% of patients with hyperparathyroidism. It is a slowly progressive disease with frequent recurrence and high incidence of local metastasis. Because of the rarity of this tumor, little is known about the pattern of lymph node metastasis. METHODS: A case of retropharyngeal lymph node metastasis found 2 years after initial diagnosis of parathyroid carcinoma is presented and discussed. RESULTS: A 67-year-old man initially was seen with asymptomatic hypercalcemia, and a 1.7-cm mass was removed along with the left hemithyroid. The mass was found to be parathyroid carcinoma. Serum calcium was again elevated 1 year later, and left neck lymph node dissection revealed an upper jugular lymph node containing parathyroid carcinoma. The patient continued to have an elevated serum calcium level, and a retropharyngeal lymph node was found by MRI and removed the following year. The patient is now without evidence of hyperparathyroidism or recurrent disease at 2-year follow-up. CONCLUSIONS: Persistent parathyroid carcinoma is often a clinical challenge because of the difficulty in localizing recurrent tumor. Retropharyngeal lymph nodes should be considered as a possible site of metastasis in patients with parathyroid carcinoma. Copyright 2003 Wiley Periodicals, Inc.
BACKGROUND:Parathyroid carcinoma is rare and accounts for approximately 1% of patients with hyperparathyroidism. It is a slowly progressive disease with frequent recurrence and high incidence of local metastasis. Because of the rarity of this tumor, little is known about the pattern of lymph node metastasis. METHODS: A case of retropharyngeal lymph node metastasis found 2 years after initial diagnosis of parathyroid carcinoma is presented and discussed. RESULTS: A 67-year-old man initially was seen with asymptomatic hypercalcemia, and a 1.7-cm mass was removed along with the left hemithyroid. The mass was found to be parathyroid carcinoma. Serum calcium was again elevated 1 year later, and left neck lymph node dissection revealed an upper jugular lymph node containing parathyroid carcinoma. The patient continued to have an elevated serum calcium level, and a retropharyngeal lymph node was found by MRI and removed the following year. The patient is now without evidence of hyperparathyroidism or recurrent disease at 2-year follow-up. CONCLUSIONS: Persistent parathyroid carcinoma is often a clinical challenge because of the difficulty in localizing recurrent tumor. Retropharyngeal lymph nodes should be considered as a possible site of metastasis in patients with parathyroid carcinoma. Copyright 2003 Wiley Periodicals, Inc.
Authors: Janneke E Witteveen; Harm R Haak; Job Kievit; Hans Morreau; Johannes A Romijn; Neveen A T Hamdy Journal: Horm Cancer Date: 2010-11-19 Impact factor: 3.869