Large atypical parathyroid tumor - a diagnostic conundrum

Saikat Mitra; Shouvanik Satpathy; Devmalya Banerjee; Sugat Sanyal

doi:10.4322/acr.2024.514

Clinical Case Report

Large atypical parathyroid tumor - a diagnostic conundrum

Saikat Mitra; Shouvanik Satpathy; Devmalya Banerjee; Sugat Sanyal

http://dx.doi.org/10.4322/acr.2024.514 Autops Case Rep, vol.14, e2024514, 2024

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Abstract

Atypical parathyroid tumor (APT) is a rare neoplasm of the parathyroid gland, which shows atypical cytological or architectural features and lacks definite diagnosis criteria for malignancy. These cases can cause diagnostic challenges owing to their rarity and similarity with thyroid neoplasm on imaging and fine needle aspiration cytology. Also, differentiating APT from giant parathyroid adenoma or parathyroid carcinoma can be challenging based on clinical, imaging or cytological features. A 49-year-old male presented with clinical features of hyperparathyroidism. On laboratory evaluation, his serum calcium and serum parathyroid hormone was elevated. Imaging studies suggested a possibility of left inferior parathyroid neoplasm, and fine needle aspiration cytology showed features suggestive of parathyroid neoplasm. However, exact categorization of parathyroid tumor was difficult in pre-operative work-up. Possibilities of giant parathyroid adenoma as well as parathyroid carcinoma were considered. A final diagnosis of an atypical parathyroid tumor was made after detailed histopathological evaluation given focal capsular invasion but lack of unequivocal evidence of malignancy in the resected specimen. APT is a rare neoplasm of uncertain malignant potential. Knowledge of the radiological and pathological features will be helpful in accurately identifying the lesion and avoiding misdiagnosis.

Keywords

Parathyroid adenoma, Aspiration, fine Needle, hyperparathyroidism, Histopathology, Parathyroid Carcinoma

References

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Submitted date:
02/23/2024

Accepted date:
07/28/2024

Publication date:
09/12/2024

Large atypical parathyroid tumor - a diagnostic conundrum

Saikat Mitra; Shouvanik Satpathy; Devmalya Banerjee; Sugat Sanyal

Abstract

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