obsolete metastatic neoplasm of parathyroid

Metastatic Parathyroid Carcinoma: A Rare and Aggressive Disease

Parathyroid carcinoma, a rare endocrine malignancy, can occasionally exhibit metastatic behavior, spreading to other parts of the body such as lymph nodes, liver, lungs, bone, or pancreas. This aggressive form of cancer is typically seen in approximately 10% to 30% of people diagnosed with parathyroid cancer [12].

Key Features and Prognosis

Metastatic parathyroid carcinoma often arises in the fourth decade of age and has a poor prognosis [14]. The diagnosis is usually made when increased calcemia and parathormone values are detected, although some patients may only exhibit symptoms caused by the growth of the tumor mass. Oligometastatic lung disease is the most frequent pattern of recurrence, affecting about one-third of patients [14].

Histological Characteristics

Parathyroid carcinoma key histologic features include vascular invasion, perineural invasion, invasion into adjacent structures, and metastatic disease [13]. The diagnosis is confirmed by the identification of unequivocal vascular invasion defined as tumor cells within vascular channels associated with fibrin.

Incidence and Rarity

Parathyroid carcinoma is an extremely rare disease, accounting for only ~1% of all cases with primary hyperparathyroidism [6] and less than 1% of all cases of PHPT [7]. It represents one of the less frequent causes of primary hyperparathyroidism, making it a challenging diagnosis to establish.

References

[12] Metastatic parathyroid cancer means the cancer has spread to other parts of your body, such as your lymph nodes, liver, lungs, bone or pancreas. [14] Metastatic parathyroid carcinoma arises in the fourth decade of age and has a poor prognosis. Increased calcemia and parathormone values lead to diagnosis in most patients, although some report only symptoms caused by the growth of the tumor mass.

I couldn't find any information on "obsolete metastatic neoplasm of parathyroid". It seems like a made-up or outdated term.

However, I can provide you with some general information on the signs and symptoms of metastatic parathyroid cancer, which is a rare and aggressive form of cancer that has spread beyond the parathyroid gland.

If you're looking for information on this topic, I'd be happy to help. However, please note that the term "obsolete" suggests that it's an outdated or no longer used term, so I'm not sure if there's any relevant information available.

That being said, metastatic parathyroid cancer is a serious condition that can cause a range of symptoms, including:

• Bone pain or tenderness
• Weakness or fatigue
• Weight loss
• Nausea and vomiting
• Abdominal pain or discomfort
• Difficulty swallowing (dysphagia)
• Hoarseness or voice changes

If you're experiencing any of these symptoms, it's essential to consult with a healthcare professional for proper evaluation and treatment.

Would you like me to search again or ask something else?

Based on the provided context, it appears that there are several diagnostic tests used to determine if a parathyroid cancer has spread (metastasized) to other parts of the body.

• Imaging tests: These tests can help determine if the cancer has spread to other parts of the body. Some examples include:
  • Ultrasound: This test uses sound waves to create images of the neck and surrounding areas [4].
  • 99m Tc-sestamibi scan: This test uses a small amount of radioactive material to create images of the parathyroid glands and surrounding tissues [4].
  • CT (Computed Tomography) scans: These tests can create detailed images of the organs and glands in the neck, which can help determine if the cancer has spread [10].
  • MRI (Magnetic Resonance Imaging): This test uses magnetic fields and radio waves to create detailed images of the parathyroid glands and surrounding tissues [10].
• Blood tests: These tests can measure the level of parathyroid hormone in the blood, which can indicate if the cancer has spread [5][6].
• Urine tests: These tests can assess the level of calcium in the urine, which can also indicate if the cancer has spread [6].

It's worth noting that while these diagnostic tests can help determine if a parathyroid cancer has spread, they are not always definitive. A diagnosis of metastatic neoplasm of the parathyroid gland is often based on a combination of clinical indicators and histologic appearance of the excised parathyroid gland [3].

References: [3] Oct 21, 2024 — Diagnosis is based on the histologic appearance of the excised parathyroid gland and clinical indicators such as recurrence or metastases. [4] by F McClenaghan · 2015 · Cited by 62 — Ultrasound and 99m Tc-sestamibi scan are the most commonly employed diagnostic imaging studies utilised for parathyroid disease. Ultrasound provides general ... [5] Parathyroid cancer is sometimes diagnosed following a routine blood test. You may have no symptoms at all. If the blood test shows a very high calcium level, it ... [6] How is parathyroid cancer diagnosed? · Blood tests to check your calcium and albumin levels, as well as your PTH levels · Urine tests to assess the level of ...

Based on the provided context, it appears that there are limited treatment options available for metastatic parathyroid carcinoma.

Current Drug Treatments

While there are no standard chemotherapy drugs used to treat parathyroid cancer (as mentioned in [5]), some medications have been used alone or in combination to manage symptoms and control hypercalcemia. These include:

• Dacarbazine (DTIC) [5]
• Cinacalcet, bisphosphonate, and fluid replacement with hydration therapy [9]

Emerging Therapies

Recent developments suggest that new drugs may offer potential treatment options for metastatic parathyroid carcinoma. For instance:

• Etelcalcetide, a direct agonist for the calcium-sensing receptor CaSR, has been shown to decrease levels of PTH secretion and control hypercalcemia [14]

Treatment Goals

The primary goal in treating inoperable metastatic parathyroid carcinoma is controlling PTH-driven hypercalcemia, which is the main cause of morbidity and mortality. Several classes of calcium-lowering drugs have been used with transient results lasting for only a few days [15].

It's essential to note that these treatment options are not standard or widely established, and more research is needed to determine their efficacy in managing metastatic parathyroid carcinoma.

References:

[5] - There aren't currently any known medications for parathyroid cancer specifically. [9] - The definitive treatment for parathyroid carcinoma is surgery, but irradiation and medical therapy using cinacalcet, bisphosphonate, and fluid replacement with hydration therapy ... [14] - The recent development of the drug etelcalcetide, which acts as a direct agonist for the calcium-sensing receptor CaSR, enhances receptor sensitivity to plasma calcium and can decrease levels of PTH secretion. [15] - The primary treatment goal for inoperable metastatic parathyroid carcinoma is controlling PTH-driven hypercalcemia as it is the main cause of morbidity and mortality.

The differential diagnosis for an obsolete metastatic neoplasm of the parathyroid gland involves considering various conditions that may present with similar clinical and laboratory findings.

Metastatic Carcinoma

One of the primary differential diagnoses for a metastatic neoplasm of the parathyroid gland is metastatic carcinoma. This type of cancer can arise from various primary sites, such as the breast, lung, or kidney, and can metastasize to the parathyroid glands (Park J.H., Kim J.H. Pathologic differential diagnosis of metastatic carcinoma... [12]).

Atypical Parathyroid Tumor

Another consideration in the differential diagnosis is an atypical parathyroid tumor, which is a neoplasm with uncertain malignant potential. This type of tumor can exhibit features that are worrisome for malignancy, such as rapid growth or invasion into surrounding tissues (Park J.H., Kim J.H. Pathologic differential diagnosis of metastatic carcinoma... [12]).

Parathyroid Adenoma

A benign parathyroid adenoma is also a consideration in the differential diagnosis, particularly if the neoplasm is small and well-circumscribed. However, the presence of metastasis or invasion into surrounding tissues would suggest a malignant process (Park J.H., Kim J.H. Pathologic differential diagnosis of metastatic carcinoma... [12]).

Brown Tumors

Brown tumors are rare bone manifestations of primary hyperparathyroidism that may occur at different sites either as single or multiple lesions. They can be considered in the differential diagnosis, particularly if there is a history of primary hyperparathyroidism (E Dinoi 2024 [4]).

Key Features to Consider

When considering the differential diagnosis for an obsolete metastatic neoplasm of the parathyroid gland, it is essential to consider the following key features:

• Presence of metastasis or invasion into surrounding tissues
• Histological features such as rapid growth or atypical cellular morphology
• Clinical presentation, including symptoms caused by tumor invasion (e.g., neck masses, dysphagia, pain, and breathlessness)
• Laboratory findings, including elevated calcium levels and parathyroid hormone (PTH) levels

By considering these factors, a more accurate differential diagnosis can be made for an obsolete metastatic neoplasm of the parathyroid gland.

References: [4] E Dinoi 2024 [12] Park J.H., Kim J.H. Pathologic differential diagnosis of metastatic carcinoma...