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  • Title: Large parathyroid tumors have an increased risk of atypia and carcinoma.
    Author: O'Neal P, Mowschenson P, Connolly J, Hasselgren PO.
    Journal: Am J Surg; 2011 Aug; 202(2):146-50. PubMed ID: 21256474.
    Abstract:
    BACKGROUND: Risk for atypia and carcinoma in large parathyroid tumors is not known. Atypia and carcinoma were determined in small (<2 g) and large (≥2 g) tumors in patients undergoing parathyroidectomy for primary hyperparathyroidism. METHODS: The study was a retrospective analysis of a 5-year prospective database. Tumor weight, histopathology, age, gender, calcium, and parathyroid hormone levels were registered. Patients with 4-gland disease were not included. RESULTS: Among 353 parathyroid tumors, 313 weighed <2 g and 40 weighed ≥2 g. There was no difference in age between groups. Patients with large tumors were more frequently men and had higher calcium and parathyroid hormone levels. Atypia was found in 4 of 313 (1.3%) and 7 of 40 (17.5%) small and large tumors, respectively (P < .05). Corresponding figures for carcinoma were 1 of 313 (.3%) and 2 of 40 (5.0%) (P < .05). CONCLUSIONS: Large parathyroid tumors have increased risk for atypia and carcinoma. Even so, most large parathyroid tumors are benign.
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