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Clinicopathological spectrum, management, and outcome of ectopic parathyroid carcinoma: Experience with 24 cases

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Abstract

Purpose

Ectopic parathyroid carcinoma (EPC) is a rare clinical entity with multiple diagnostic pitfalls, making surgical cures challenging. We assessed the clinicopathological spectrum and outcome of EPCs.

Methods

In this retrospective cohort study, 24 EPCs were identified from 133 PC patients treated at a tertiary referral center. The relationship between clinicopathological findings and locations was analyzed.

Results

The locations of EPCs were predominantly intrathyroidal (62.5%), followed by 16.7% in the mediastinum, 8.3% in the retropharyngeal space, 8.3% in the carotid sheath, and 4.2% in the upper neck. Intrathyroidal EPC patients experienced higher serum calcium (p = 0.020), a higher rate of vascular invasion (p = 0.040), and a slightly higher incidence of non-R0 initial resection (p = 0.092) than those in other ectopic locations. Intrathyroidal EPC patients also suffered a trend of higher upper aerodigestive tract (UAT) invasion rate (p = 0.070) and higher risks of distant metastasis (p = 0.037) than the other PC patients. The 5-year disease-free survival rate after surgery was slightly compromised at 41.5% in intrathyroidal EPC patients compared with 77.8% among those in other ectopic locations (p = 0.143) and 59.7% among the other PC patients (log-rank = 3.194; p = 0.074), though without statistical significance.

Conclusion

Intrathyroidal EPC might cause a more biochemically and invasively distinct PC picture compared with other PCs. Special caution should be exercised in the preoperative diagnosis and management of such cases.

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Acknowledgements

We would like to thank Prof. Bin Hu for invaluable technical guidance. This study was supported by the Bei**g Municipal Administration of Hospitals Incubating Program (PX2023009) and the National Natural Science Foundation of China (82200872).

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Author notes

  1. These authors contributed equally: Teng Zhao, Jian Huang, Yuting Wang

Authors and Affiliations

  1. Department of Thyroid and Neck Surgery, Bei**g Chaoyang Hospital, Capital Medical University, Bei**g, China

    Teng Zhao, Jian Huang, Yuting Wang, Hong Shen, **ng Liu, Dalin Feng, Jiacheng Wang, Qian Wang & Bojun Wei

  2. Department of Endocrinology, Bei**g Shijitan Hospital, Capital Medical University, Bei**g, China

    Dongxue Zhang

  3. Department of Nuclear Medicine, Bei**g Chaoyang Hospital, Capital Medical University, Bei**g, China

    Teng Zhang

  4. Department of Ultrasound, Bei**g Chaoyang Hospital, Capital Medical University, Bei**g, China

    Ruigang Lu

  5. Department of Radiology, Bei**g Chaoyang Hospital, Capital Medical University, Bei**g, China

    Hua Gu

  6. Department of Pathology, Bei**g Chaoyang Hospital, Capital Medical University, Bei**g, China

    Mulan **

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  1. Teng Zhao
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Contributions

T. Zhao, J. H., Y. W., and B. W. contributed to the study conception and design. T. Zhao, J. H., Y. W., H. S., X. L., D. F., J. W., and Q. W. collected all data. T. Zhao, D. Z., T. Zhang, R. L., H. G., M. J., and B. W. analyzed and interpreted all data. The main manuscript was written by T. Zhao and J. H. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bojun Wei.

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The authors declare no competing interests.

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This is a retrospective cohort study. The study was approved by the ethics committee of Bei**g Chaoyang Hospital.

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Written informed consent was obtained from all patients included in the study.

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Zhao, T., Huang, J., Wang, Y. et al. Clinicopathological spectrum, management, and outcome of ectopic parathyroid carcinoma: Experience with 24 cases. Endocrine (2024). https://doi.org/10.1007/s12020-024-03964-4

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