Report Of 5 Cases Of Parathyroid Carcinoma And Literature Review

Objective: to analyse clinical features,diagnose and treatment process and prognosis of 5 parathyroid carcinoma patient.The purpose of study is through reviewing relative reference to understand the feature of parathyroid carcinoma,conclude and discuss treatment method of parathyroid carcinoma to decrease the rate of misdiagnose and missed diagnose.Method: collecting 5 parathyroid carcinoma cases of The First Affiliated Hospital of Guangxi Medical University.from Jan.1999 to Dec.2017.Reviewing and concluding the 5 collected case referring to relative reference domestic and abroad.Results:(1)in collected 5 parathyroid carcinoma cases,3 female case,2 male cases,ages among 23-52,averages at 30 years old,course of disease various from decade days to decade years.(2)clinical manifestation: 3 cases of lithiasis in urinary system;3 cases of pathological fracture;3 cases of dry mouth,polydipsia,and diuresis;2 cases of nausea,emesis,and poor appetite;2 cases of lacking in strength;one case of osteodynia.1 case of tuberculum anterius vertebrarum cervicalium,1 case of evident shortness in height.(3)Examination in laboratory: 5 cases of blood calcium volume varies among 3.65 ~ 4.71mmol/L,averages at 4.14mmol/L(normal value: 2.08-2.60mmol/L),among which,4 cases of blood calcium volume higher than 3.75mmol/L;serium inorganic phosphorus volume varies among 0.4~0.52mmol/L,averages at 0.475mmol/L(normal value: 0.9~1.34mmol/L);blood alkaline phosphatase volume varies among 124~1737U/L,averages at 217U/L(normal value: 45~135U/L);blood parathyroid hormone volume varies among 182~4699.12pg/ml,averages at 1346.4pg/ml(normal value: 6.0~80.0pg/ml).1 case of intraoperative frozen pathological examination diagnose,2 cases of post-operation conventional disease inspection and immunohistochemical diagnose;1 case of postoperative disease inspection misdiagnose as adenoma;1 case of 3 times of postoperative disease inspection misdiagnose as parathyroid adenoma;diagnose as adenoma after fourth postoperative disease inspection.(4)Treatment: 1 case of routine affected side parathyroid gland excision;2 cases of routine affected side parathyroid adenoma resection and total resection of affected side thyroid;2 cases of outine affected side parathyroid adenoma resection,total resection of affected side thyroid times and recurrent laryngeal nerve surgical exploration.Conclusion: 1.parathyroid carcinoma shows no specificity in clinical feature.Parathyroid carcinoma usually implicates in skeleton and urinary system;2.parathyroid carcinoma in early stage is difficult to be diagnosed accurately,patients may show hyperparathyroidism symptom,some patients even show hypercalcaemia symptom;3.usually parathyroid carcinoma can be diagnosed in pathological examination inspection,for PA and PC show no evident cell morphological differences,in showing of envelope,blood vessel and nerve invasion can be diagnosed as malignancy.parathyroid carcinoma as a cancer lack of obvious pathological feature,shall only be diagnosed accurately in long-term post operation follow up at the appearance of metastasis and lymphatic metastasis.