A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy
Abstract Objective To describe common intraoperative and pathologic findings of atypical parathyroid tumors (APTs) and evaluate clinical outcomes in patients undergoing parathyroidectomy. Methods In this multi‐institutional retrospective case series, data were collected from patients who underwent p...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.814 |
| _version_ | 1818470527118868480 |
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| author | Alice L. Tang Benjamin Aunins Katherine Chang James C. Wang Matthew Hagen Lan Jiang Cortney Y. Lee Reese W. Randle Jeffery J. Houlton David Sloan David L. Steward |
| author_facet | Alice L. Tang Benjamin Aunins Katherine Chang James C. Wang Matthew Hagen Lan Jiang Cortney Y. Lee Reese W. Randle Jeffery J. Houlton David Sloan David L. Steward |
| author_sort | Alice L. Tang |
| collection | DOAJ |
| description | Abstract Objective To describe common intraoperative and pathologic findings of atypical parathyroid tumors (APTs) and evaluate clinical outcomes in patients undergoing parathyroidectomy. Methods In this multi‐institutional retrospective case series, data were collected from patients who underwent parathyroidectomy from 2000 to 2018 from three tertiary care institutions. APTs were defined according to the AJCC eighth edition guidelines and retrospective chart review was performed to evaluate the incidence of recurrent laryngeal nerve injury, recurrence of disease, and disease‐specific mortality. Results Twenty‐eight patients were identified with a histopathologic diagnosis of atypical tumor. Mean age was 56 years (range, 23–83) and 68% (19/28) were female. All patients had an initial diagnosis of primary hyperparathyroidism with 21% (6/28) exhibiting clinical loss of bone density and 32% (9/28) presenting with nephrolithiasis or renal dysfunction. Intraoperatively, 29% (8/28) required thyroid lobectomy, 29% (8/28) had gross adherence to adjacent structures and 46% (13/28) had RLN adherence. The most common pathologic finding was fibrosis 46% (13/28). Postoperative complications include RLN paresis/paralysis in 14% (4/28) and hungry bone syndrome in 7% (2/28). No patients with a diagnosis of atypical tumor developed recurrent disease, however there was one patient that had persistent disease and hypercalcemia that is being observed. There were 96% (27/28) patients alive at last follow‐up, with one death unrelated to disease. Conclusion Despite the new AJCC categorization of atypical tumors staged as Tis, we observed no recurrence of disease after resection and no disease‐specific mortality. However, patients with atypical tumors may be at increased risk for recurrent laryngeal nerve injury and incomplete resection. |
| first_indexed | 2024-04-13T21:38:11Z |
| format | Article |
| id | doaj.art-a065dc08690a43448731ee38adcb4d34 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-04-13T21:38:11Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-a065dc08690a43448731ee38adcb4d342022-12-22T02:28:51ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-06-017390190510.1002/lio2.814A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomyAlice L. Tang0Benjamin Aunins1Katherine Chang2James C. Wang3Matthew Hagen4Lan Jiang5Cortney Y. Lee6Reese W. Randle7Jeffery J. Houlton8David Sloan9David L. Steward10Department of Otolaryngology – Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio USADepartment of Otolaryngology – Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio USADepartment of Otolaryngology—Head and Neck Surgery Washington University in St. Louis St. Louis Missouri USADepartment of Otolaryngology – Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio USADepartment of Pathology University of Cincinnati Cincinnati Ohio USADepartment of Surgery University of Kentucky Lexington Kentucky USADepartment of Surgery University of Kentucky Lexington Kentucky USADepartment of Surgery Wake Forest Baptist Health Winston‐Salem North Carolina USADepartment of Otolaryngology—Head and Neck Surgery University of Washington Seattle Washington USADepartment of Surgery University of Kentucky Lexington Kentucky USADepartment of Otolaryngology – Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio USAAbstract Objective To describe common intraoperative and pathologic findings of atypical parathyroid tumors (APTs) and evaluate clinical outcomes in patients undergoing parathyroidectomy. Methods In this multi‐institutional retrospective case series, data were collected from patients who underwent parathyroidectomy from 2000 to 2018 from three tertiary care institutions. APTs were defined according to the AJCC eighth edition guidelines and retrospective chart review was performed to evaluate the incidence of recurrent laryngeal nerve injury, recurrence of disease, and disease‐specific mortality. Results Twenty‐eight patients were identified with a histopathologic diagnosis of atypical tumor. Mean age was 56 years (range, 23–83) and 68% (19/28) were female. All patients had an initial diagnosis of primary hyperparathyroidism with 21% (6/28) exhibiting clinical loss of bone density and 32% (9/28) presenting with nephrolithiasis or renal dysfunction. Intraoperatively, 29% (8/28) required thyroid lobectomy, 29% (8/28) had gross adherence to adjacent structures and 46% (13/28) had RLN adherence. The most common pathologic finding was fibrosis 46% (13/28). Postoperative complications include RLN paresis/paralysis in 14% (4/28) and hungry bone syndrome in 7% (2/28). No patients with a diagnosis of atypical tumor developed recurrent disease, however there was one patient that had persistent disease and hypercalcemia that is being observed. There were 96% (27/28) patients alive at last follow‐up, with one death unrelated to disease. Conclusion Despite the new AJCC categorization of atypical tumors staged as Tis, we observed no recurrence of disease after resection and no disease‐specific mortality. However, patients with atypical tumors may be at increased risk for recurrent laryngeal nerve injury and incomplete resection.https://doi.org/10.1002/lio2.814atypicalparathyroid tumorsrecurrent laryngeal nerve |
| spellingShingle | Alice L. Tang Benjamin Aunins Katherine Chang James C. Wang Matthew Hagen Lan Jiang Cortney Y. Lee Reese W. Randle Jeffery J. Houlton David Sloan David L. Steward A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy Laryngoscope Investigative Otolaryngology atypical parathyroid tumors recurrent laryngeal nerve |
| title | A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy |
| title_full | A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy |
| title_fullStr | A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy |
| title_full_unstemmed | A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy |
| title_short | A multi‐institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy |
| title_sort | multi institutional study evaluating and describing atypical parathyroid tumors discovered after parathyroidectomy |
| topic | atypical parathyroid tumors recurrent laryngeal nerve |
| url | https://doi.org/10.1002/lio2.814 |
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