Recognition by the surgeon that the tumor is malignant rather than benign and performing the appropriate surgery, including removal of the lymph nodes , is important for good results. Malignancy is more likely if there is a very high serum calcium , a palpable or hard mass in the neck or hoarseness due to paralysis of the vocal cords on the same side.
Because this tumor usually grows slowly and because the main clinical problem is usually the effects of the elevated calcium levels, palliative reduction or debulking of the primary tumor or metastases is recommended. This may lower the blood calcium level, which is difficult to treat any other way.
Types Parathyroid carcinomas are tumors with chief cell, oxyphil, clear cell and mixed cell types.
How It Spreads Parathyroid tumors can spread directly to adjacent tissues, as well as through the lymphatic system to nearby lymph nodes and via the bloodstream to distant sites, usually the lung, bones and liver.
What Causes It Increased incidence following exposure to low-dose therapeutic radiation or in families with familial hyperparathyroidism or MEN 1.
