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Parathyroid Retrospective Analysis of Neoplasms Incidence (pTRANI Study): An Italian Multicenter Study on Parathyroid Carcinoma and Atypical Parathyroid Tumour

2023; Multidisciplinary Digital Publishing Institute; Volume: 12; Issue: 19 Linguagem: Inglês

10.3390/jcm12196297

2077-0383

Angela Gurrado, Alessandro Pasculli, Nicola Avenia, Rocco Bellantone, Marco Boniardi, Isabella Merante Boschin, Pietro Giorgio Calò, Michele Camandona, Giuseppe Cavallaro, Fabio Cianchi, Giovanni Conzo, Vito D’Andrea, Carmela De Crea, Loredana De Pasquale, Paolo Del Rio, Giovanna Di Meo, Gianlorenzo Dionigi, Chiara Dobrinja, Giovanni Docimo, Fausto Famà, Attilio Galimberti, Luciano Giacomelli, Giuseppa Graceffa, Maurizio Iacobone, Nadia Innaro, Celestino Pio Lombardi, Gabriele Materazzi, Fabio Medas, Barbara Mullineris, Luigi Oragano, N Palestini, Giuliano Perigli, Angela Pezzolla, Francesco Paolo Prete, Marco Raffaelli, Giuseppina Renzulli, L Rosato, Grégorio Scerrino, Lucia Ilaria Sgaramella, Salvatore Sorrenti, Carlotta Testini, Massimiliano Veroux, Guido Gasparri, Mario Testini, pTRANI Study Group,

Genetic Syndromes and Imprinting

Parathyroid cancer (PC) is a rare sporadic or hereditary malignancy whose histologic features were redefined with the 2022 WHO classification. A total of 24 Italian institutions designed this multicenter study to specify PC incidence, describe its clinical, functional, and imaging characteristics and improve its differentiation from the atypical parathyroid tumour (APT).All relevant information was collected about PC and APT patients treated between 2009 and 2021.Among 8361 parathyroidectomies, 351 patients (mean age 59.0 ± 14.5; F = 210, 59.8%) were divided into the APT (n = 226, 2.8%) and PC group (n = 125, 1.5%). PC showed significantly higher rates (p < 0.05) of bone involvement, abdominal, and neurological symptoms than APT (48.8% vs. 35.0%, 17.6% vs. 7.1%, 13.6% vs. 5.3%, respectively). Ultrasound (US) diameter >3 cm (30.9% vs. 19.3%, p = 0.049) was significantly more common in the PC. A significantly higher frequency of local recurrences was observed in the PC (8.0% vs. 2.7%, p = 0.022). Mortality due to consequences of cancer or uncontrolled hyperparathyroidism was 3.3%.Symptomatic hyperparathyroidism, high PTH and albumin-corrected serum calcium values, and a US diameter >3 cm may be considered features differentiating PC from APT. 2022 WHO criteria did not impact the diagnosis.