18 August 2018

QJM Advance Access published December 22, 2016

 QJM: An International Journal of Medicine, 2016, 1-1
doi: 10.1093/qjmed/hcw207 

Letter to Editor

Authors: C.V. Tong1, L.T. Loh2 and Z. Hussein3 

Institutions: 1Medical Department, Hospital Melaka, Melaka, Malaysia, 2Medical Department, Hospital Sultanah Aminah, Johor Bahru, Malaysia and 3Endocrinology Unit, Department of Medicine, Hospital Putrajaya, Putrajaya, Malaysia Address correspondence to C. V. Tong, Department of Medicine, Hospital Melaka, Jalan Haji Mufti Khalil, 75400, Melaka, Malaysia. email: tchinvoon@yahoo.com Dear editor, 

We read with great interest the case shared by Dr Athanasios Fountas et al. and their experience in managing a patient with parathyroid carcinoma. This is indeed a rare condition, accounting for only 0.3–2.1% of primary hyperparathyroidism. 1,2 In our own tertiary endocrine center, the percentage of parathyroid carcinoma among patients with primary hyperparathyroidism from year 2003–12 was only 1.4%. Surgery remains the mainstay of therapy and provides potential cure; even in recurrent disease. However, reoperation for recurrent or persistent parathyroid carcinoma is associated with substantial morbidity.All our patients with parathyroid carcinoma are monitored lifelong. In event of recurrence, surgery, if feasible, is still our first line of management. Therapies such as denosumab despite being effective in controlling hypercalcemia for long term period, remains in our opinion, a palliative one.4,5 A global registry for parathyroid carcinoma would be beneficial for those treating this rare disease in the future.

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