24th European Congress of Endocrinology, Milan, Italy, 21 - 24 May 2022, vol.81, pp.175
Background Atypical parathyroid adenoma (APA) is a rare disease that can be challenging to distinguish from benign parathyroid adenoma. APA shows some laboratory and histopathological features with parathyroid cancer. This study attempts to compare clinical, laboratory, radiologic and histopathological characteristics in APA and parathyroid adenoma (PA).
Methods This was a retrospective study was based on the database of eighty-two subjects who underwent surgery for primary hyperparathyroidism at a tertiary referral center between 2010 and 2021. Forty-one patients with APA matched by age and gender to controls with PA. Clinical, laboratory, radiologic and characteristics were obtained from the hospital database.
Results Forty-five (54.8%) of primary hyperparathyroidism (PHPT) patients were symptomatic, 36 (90%) had nephrolithiasis, 6 (15%) had fracture and 3 (7.5%) had hypercalcaemic crisis. APA patients present with significantly inceased serum calcium, parathormone (PTH) and alkalen phosphatase levels (P!.001, all). No significant difference was observed in the results of bone mineral density (BMD), T-scores and Z-scores. The size of adenoma was significantly greater in APA group (24 (8.8–70) mm vs. 12 (3.8–32) mm, PZ0.005).
Our study revealed that increased preoperative serum calcium, parathormone,
alkalen phosphatase concentrations and parathyroid adenoma size on ultrasound
may have predicted the atypical parathyroid adenoma.