Metastatic Parathyroid Cancer
Current Clinical Trials
Metastatic disease can appear shortly after the initial diagnosis and operation
or for up to 20 years later.[1] 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.[2] Approximately 50% of the patients who experience
recurrence will have distant metastases.[3] 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.[5] Aggressive surgical resection has been associated with a 30% long-term survival
in retrospective series.[3,6] (Refer to the PDQ summary on Hypercalcemia for more information.)
Treatment options:[1,3-10]
- 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]
Current Clinical Trials
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry 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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Wynne AG, van Heerden J, Carney JA, et al.: Parathyroid carcinoma: clinical and pathologic features in 43 patients. Medicine (Baltimore) 71 (4): 197-205, 1992.
[PUBMED Abstract]
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Busaidy NL, Jimenez C, Habra MA, et al.: Parathyroid carcinoma: a 22-year experience. Head Neck 26 (8): 716-26, 2004.
[PUBMED Abstract]
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Sandelin K, Tullgren O, Farnebo LO: Clinical course of metastatic parathyroid cancer. World J Surg 18 (4): 594-8; discussion 599, 1994 Jul-Aug.
[PUBMED Abstract]
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Favia G, Lumachi F, Polistina F, et al.: Parathyroid carcinoma: sixteen new cases and suggestions for correct management. World J Surg 22 (12): 1225-30, 1998.
[PUBMED Abstract]
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Shane E: Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab 86 (2): 485-93, 2001.
[PUBMED Abstract]
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Obara T, Okamoto T, Ito Y, et al.: Surgical and medical management of patients with pulmonary metastasis from parathyroid carcinoma. Surgery 114 (6): 1040-8; discussion 1048-9, 1993.
[PUBMED Abstract]
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Vetto JT, Brennan MF, Woodruf J, et al.: Parathyroid carcinoma: diagnosis and clinical history. Surgery 114 (5): 882-92, 1993.
[PUBMED Abstract]
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Sandelin K: Parathyroid carcinoma. Cancer Treat Res 89: 183-92, 1997.
[PUBMED Abstract]
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Iacobone M, Lumachi F, Favia G: Up-to-date on parathyroid carcinoma: analysis of an experience of 19 cases. J Surg Oncol 88 (4): 223-8, 2004.
[PUBMED Abstract]
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Fraker DL: Parathyroid Tumors. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005, pp 1521-27.
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Clayman GL, Gonzalez HE, El-Naggar A, et al.: Parathyroid carcinoma: evaluation and interdisciplinary management. Cancer 100 (5): 900-5, 2004.
[PUBMED Abstract]
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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]
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