PARATHYROID CARCINOMA - THE PRINCESS-MARGARET-HOSPITAL EXPERIENCE

Purpose: Carcinoma of the parathyroid gland is a rare disease represen ting 0.5 to 4% of patients with primary hyperparathyroidism. We review ed our experience with this disease, with special emphasis on the role of adjuvant postoperative radiotherapy. Methods: A retrospective revi ew was conducted of all cases of parathyroid carcinoma referred to the Princess Margaret Hospital (PMH) from 1958-1996. Ten patients were id entified. Their clinical features, management details, and treatment o utcome are described. Results: There were 5 men and 5 women with a mea n age of 53 years. Of these, 7 patients underwent en bloc resection; a mong them, 4 had neck dissection or lymph node sampling. The other 3 p atients underwent only limited surgery to remove the tumor. Seven pati ents were referred for consideration of adjuvant radiation treatment. Six patients were given adjuvant radiation therapy for microscopic res idual disease. All patients tolerated the radiation treatment web, wit h minimal side effects. The 7 patients have been followed regularly wi th no evidence of recurrence and normal serum calcium. The mean follow -up for the 6 patients who had adjuvant radiotherapy was 62.3 months ( range 12 to 156 months). The remaining 3 patients had metastatic disea se and were referred for palliative radiotherapy. Conclusions: Our res ults in a small number of patients suggest local radiation therapy to the tumor bed may have eliminated the strong predilection for local re currence of this disease, as reported by other investigators. (C) 1998 Elsevier Science Inc.