Metastatic Parathyroid Cancer
Metastatic disease can appear shortly after the initial diagnosis and operation or for up to 20 years later. Because of the difficulty in making a histologic diagnosis, the appearance of recurrent or metastatic disease in a patient previously operated on for hypercalcemia can be the first indicator that the tumor was malignant. Approximately 50% of the patients who experience recurrence will have distant metastases. The most common site of distant metastasis is the lung.[4,5] Some patients experience years of survival even after the diagnosis of distant metastases. Aggressive surgical resection has been associated with a 30% long-term survival in retrospective series.[3,6]
- Metastasectomy: Because parathyroid carcinoma can be slow growing, resection of distant metastases can be effective for palliation and occasional cure.
- Medical management of hypercalcemia.[5,10-12]
- Surgery plus radiation therapy.
- Radiation therapy.
- Chemotherapy. Anecdotal reports show that short-term remissions with chemotherapy are possible.[5,10]
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with metastatic parathyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.References
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- Rahbari R, Kebebew E: Parathyroid tumors. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1473-9.
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- Peacock M, Bilezikian JP, Klassen PS, et al.: Cinacalcet hydrochloride maintains long-term normocalcemia in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 90 (1): 135-41, 2005. [PUBMED Abstract]