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Parathyroid cancer differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Parathyroid cancer must be differentiated from other conditions presenting as a neck swelling.[1]

Differentiating Parathyroid cancer from other Diseases

Parathyroid cancer must be differentiated from other conditions presenting as neck swelling. The differentials include the following:

Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Hypopharyngeal cancer[2][3][4]
  • More common in males
  • Age: 55-65 years old
  • Incidence: < 1/100,000 in U.S.
  • More common in Japan, India, Iran
 − + − −
Parathyroid cancer[5][6][7]
  • Incidence: Rare
  • Mean age : 44-54 years old
  • Gender: Female predilection
 + +
Carotid body tumors[8][9][10][11]
  • Age: 26-55 years
  • Male predominance
 + − −
Paraganglioma[12][13][14]
  • Age 50-70 years
  • More in females
 − − − −
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Schwannoma[15][16][17]
  • Rare tumor
  • Incidence: 1-10%
 + ±
  • Multiple
  • Slow growing nodules on the skin
  • May be normal
  • Encapsulated neural tissue growth
Lymphoma [18][19][20][21][22][23]
  • Age: Predilection for older age
  • Mean age: 55
 − ±
  • On complete node analysis four patterns are described:
    • Nodular/follicular
    • Diffuse pattern
    • Transition from a nodular to a diffuse pattern in adjacent nodes
    • Transition from a lower to a higher grade of involvement within a single node
Liposarcoma [24][25][26][27]
  • Rare tumor
  • Age: Relatively in older age
  • Gender: No gender predilection
  • Mobile mass
  • Few symptoms until they grow enough to compress the surrounding structures
  • Symptoms of neural deficit, pain, tingling, or skin changes
 ± −
  • Intact skin and normal color
  • Normal
 −
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Lipoma [28][29][30]
  • One or multiple soft, painless skin nodules
  • May causes pain or compressive symptoms
 ± −
  • Normal
  • Normal
  • Diagnoses is usually clinical
  • Tissue biopsy may show:
    • Bundle of well-demarcated lipocytes
    • Single nuclei aligned to the side
    • Intra-cytoplasimic fat granules
Glomus vagale, glomus jugulare tumors[31][32][33][34][35][36]
  • Rare tumor
  • Painless slowly enlarging mass in the neck
 − ±
  • Normal
 −
Metastatic head and neck cancer[37][38] − ±
  • Vary depending on the underlying cancer
 −
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Other Laryngeal cancer[39][40] Benign/Malignant
  • Older males
  • Younger patients with HPV infection or smoking history
 ± ±

human papillomavirus (HPV) infection

−
Arteriovenous fistula

[41][42]

  • Depends on the risk factors
 − −
  • Varies depending on the etiology
 −
Thyroid nodule/ Goiter

[43][44][45][46]

  • Female predominance
  • Young age (benign causes)
  • Old age (malignant etiology)
 ± ±
  • Painless
  • Non-tender
  • Asymmetrical neck mass in front of neck
  • With smooth overlying skin
  • Nodular surface
  • Depending on the type:
  • Normal to low TSH levels in case of malignancy
  • High TSH levels in case of goiter
 −
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings

Reference

  1. ↑ Parathyroid cancer. Canadian Cancer Society (2015). http://www.cancer.ca/en/cancer-information/cancer-type/parathyroid/parathyroid-cancer/?region=bc Accessed on December 29, 2015
  2. ↑ Helliwell TR (February 2003). “acp Best Practice No 169. Evidence based pathology: squamous carcinoma of the hypopharynx”. J. Clin. Pathol. 56 (2): 81–5. PMC 1769882. PMID 12560383.
  3. ↑ International Journal of Recent Scientific Research. doi:10.24327/IJRSR. ISSN 0976-3031. Missing or empty |title= (help)
  4. ↑ Maasland, Denise HE; van den Brandt, Piet A; Kremer, Bernd; Goldbohm, R Alexandra; Schouten, Leo J (2014). “Alcohol consumption, cigarette smoking and the risk of subtypes of head-neck cancer: results from the Netherlands Cohort Study”. BMC Cancer. 14 (1). doi:10.1186/1471-2407-14-187. ISSN 1471-2407.
  5. ↑ Wei CH, Harari A (March 2012). “Parathyroid carcinoma: update and guidelines for management”. Curr Treat Options Oncol. 13 (1): 11–23. doi:10.1007/s11864-011-0171-3. PMID 22327883.
  6. ↑ Sahasranam P, Tran MT, Mohamed H, Friedman TC (August 2007). “Multiglandular parathyroid carcinoma: a case report and brief review”. South. Med. J. 100 (8): 841–4. doi:10.1097/SMJ.0b013e318073ca37. PMID 17713315.
  7. ↑ Holmes EC, Morton DL, Ketcham AS (April 1969). “Parathyroid carcinoma: a collective review”. Ann. Surg. 169 (4): 631–40. PMC 1387475. PMID 4886854.
  8. ↑ Sajid MS, Hamilton G, Baker DM (August 2007). “A multicenter review of carotid body tumour management”. Eur J Vasc Endovasc Surg. 34 (2): 127–30. doi:10.1016/j.ejvs.2007.01.015. PMID 17400487.
  9. ↑ Boedeker CC, Ridder GJ, Schipper J (2005). “Paragangliomas of the head and neck: diagnosis and treatment”. Fam. Cancer. 4 (1): 55–9. doi:10.1007/s10689-004-2154-z. PMID 15883711.
  10. ↑ Pellitteri PK, Rinaldo A, Myssiorek D, Gary Jackson C, Bradley PJ, Devaney KO, Shaha AR, Netterville JL, Manni JJ, Ferlito A (July 2004). “Paragangliomas of the head and neck”. Oral Oncol. 40 (6): 563–75. doi:10.1016/j.oraloncology.2003.09.004. PMID 15063383.
  11. ↑ Darouassi Y, Alaoui M, Mliha Touati M, Al Maghraoui O, En-Nouali A, Bouaity B, Ammar H (August 2017). “Carotid Body Tumors: A Case Series and Review of the Literature”. Ann Vasc Surg. 43: 265–271. doi:10.1016/j.avsg.2017.03.167. PMID 28478173.
  12. ↑ Neumann HP, Pawlu C, Peczkowska M, Bausch B, McWhinney SR, Muresan M, Buchta M, Franke G, Klisch J, Bley TA, Hoegerle S, Boedeker CC, Opocher G, Schipper J, Januszewicz A, Eng C (August 2004). “Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations”. JAMA. 292 (8): 943–51. doi:10.1001/jama.292.8.943. PMID 15328326.
  13. ↑ Erickson D, Kudva YC, Ebersold MJ, Thompson GB, Grant CS, van Heerden JA, Young WF (November 2001). “Benign paragangliomas: clinical presentation and treatment outcomes in 236 patients”. J. Clin. Endocrinol. Metab. 86 (11): 5210–6. doi:10.1210/jcem.86.11.8034. PMID 11701678.
  14. ↑ O’Riordain DS, Young WF, Grant CS, Carney JA, van Heerden JA (September 1996). “Clinical spectrum and outcome of functional extraadrenal paraganglioma”. World J Surg. 20 (7): 916–21, discussion 922. PMID 8678971.
  15. ↑ Hilton DA, Hanemann CO (April 2014). “Schwannomas and their pathogenesis”. Brain Pathol. 24 (3): 205–20. doi:10.1111/bpa.12125. PMID 24450866.
  16. ↑ Albert P, Patel J, Badawy K, Weissinger W, Brenner M, Bourhill I, Parnell J (2017). “Peripheral Nerve Schwannoma: A Review of Varying Clinical Presentations and Imaging Findings”. J Foot Ankle Surg. 56 (3): 632–637. doi:10.1053/j.jfas.2016.12.003. PMID 28237565.
  17. ↑ Wong B, Bathala S, Grant D (January 2017). “Laryngeal schwannoma: a systematic review”. Eur Arch Otorhinolaryngol. 274 (1): 25–34. doi:10.1007/s00405-016-4013-6. PMID 27020268. Vancouver style error: initials (help)
  18. ↑ Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT (December 1982). “Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute”. Cancer. 50 (12): 2699–707. PMID 7139563.
  19. ↑ Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT (December 1982). “Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute”. Cancer. 50 (12): 2699–707. PMID 7139563.
  20. ↑ Negri E, Little D, Boiocchi M, La Vecchia C, Franceschi S (August 2004). “B-cell non-Hodgkin’s lymphoma and hepatitis C virus infection: a systematic review”. Int. J. Cancer. 111 (1): 1–8. doi:10.1002/ijc.20205. PMID 15185336.
  21. ↑ Moormeier JA, Williams SF, Golomb HM (February 1990). “The staging of non-Hodgkin’s lymphomas”. Semin. Oncol. 17 (1): 43–50. PMID 2406917.
  22. ↑ Negri E, Little D, Boiocchi M, La Vecchia C, Franceschi S (August 2004). “B-cell non-Hodgkin’s lymphoma and hepatitis C virus infection: a systematic review”. Int. J. Cancer. 111 (1): 1–8. doi:10.1002/ijc.20205. PMID 15185336.
  23. ↑ Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT (December 1982). “Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute”. Cancer. 50 (12): 2699–707. PMID 7139563.
  24. ↑ Evans HL (January 2007). “Atypical lipomatous tumor, its variants, and its combined forms: a study of 61 cases, with a minimum follow-up of 10 years”. Am. J. Surg. Pathol. 31 (1): 1–14. doi:10.1097/01.pas.0000213406.95440.7a. PMID 17197914.
  25. ↑ Conyers R, Young S, Thomas DM (2011). “Liposarcoma: molecular genetics and therapeutics”. Sarcoma. 2011: 483154. doi:10.1155/2011/483154. PMC 3021868. PMID 21253554.
  26. ↑ Alaggio R, Coffin CM, Weiss SW, Bridge JA, Issakov J, Oliveira AM, Folpe AL (May 2009). “Liposarcomas in young patients: a study of 82 cases occurring in patients younger than 22 years of age”. Am. J. Surg. Pathol. 33 (5): 645–58. doi:10.1097/PAS.0b013e3181963c9c. PMID 19194281.
  27. ↑ Serpell JW, Chen RY (July 2007). “Review of large deep lipomatous tumours”. ANZ J Surg. 77 (7): 524–9. doi:10.1111/j.1445-2197.2007.04042.x. PMID 17610686.
  28. ↑ de Bree E, Karatzanis A, Hunt JL, Strojan P, Rinaldo A, Takes RP, Ferlito A, de Bree R (May 2015). “Lipomatous tumours of the head and neck: a spectrum of biological behaviour”. Eur Arch Otorhinolaryngol. 272 (5): 1061–77. doi:10.1007/s00405-014-3065-8. PMID 24800932.
  29. ↑ Rydholm A, Berg NO (December 1983). “Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma”. Acta Orthop Scand. 54 (6): 929–34. PMID 6670522.
  30. ↑ Myhre-Jensen O (June 1981). “A consecutive 7-year series of 1331 benign soft tissue tumours. Clinicopathologic data. Comparison with sarcomas”. Acta Orthop Scand. 52 (3): 287–93. PMID 7282321.
  31. ↑ Urquhart AC, Johnson JT, Myers EN, Schechter GL (April 1994). “Glomus vagale: paraganglioma of the vagus nerve”. Laryngoscope. 104 (4): 440–5. doi:10.1288/00005537-199404000-00008. PMID 8164483.
  32. ↑ Valavanis A, Schubiger O, Oguz M (1983). “High-resolution CT investigation of nonchromaffin paragangliomas of the temporal bone”. AJNR Am J Neuroradiol. 4 (3): 516–9. PMID 6308990.
  33. ↑ Urquhart AC, Johnson JT, Myers EN, Schechter GL (April 1994). “Glomus vagale: paraganglioma of the vagus nerve”. Laryngoscope. 104 (4): 440–5. doi:10.1288/00005537-199404000-00008. PMID 8164483.
  34. ↑ Stein PP, Black HR (January 1991). “A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution’s experience”. Medicine (Baltimore). 70 (1): 46–66. PMID 1988766.
  35. ↑ Sajid MS, Hamilton G, Baker DM (August 2007). “A multicenter review of carotid body tumour management”. Eur J Vasc Endovasc Surg. 34 (2): 127–30. doi:10.1016/j.ejvs.2007.01.015. PMID 17400487.
  36. ↑ Boedeker CC, Ridder GJ, Schipper J (2005). “Paragangliomas of the head and neck: diagnosis and treatment”. Fam. Cancer. 4 (1): 55–9. doi:10.1007/s10689-004-2154-z. PMID 15883711.
  37. ↑ Gluckman JL, Robbins KT, Fried MP (1990). “Cervical metastatic squamous carcinoma of unknown or occult primary source”. Head Neck. 12 (5): 440–3. PMID 2211107.
  38. ↑ Waltonen JD, Ozer E, Hall NC, Schuller DE, Agrawal A (October 2009). “Metastatic carcinoma of the neck of unknown primary origin: evolution and efficacy of the modern workup”. Arch. Otolaryngol. Head Neck Surg. 135 (10): 1024–9. doi:10.1001/archoto.2009.145. PMID 19841343.
  39. ↑ Feldman PS, Kaplan MJ, Johns ME, Cantrell RW (November 1983). “Fine-needle aspiration in squamous cell carcinoma of the head and neck”. Arch Otolaryngol. 109 (11): 735–42. PMID 6639441.
  40. ↑ Grénman R, Koivunen P, Minn H (2015). “[Laryngeal cancer in Finland]”. Duodecim (in Finnish). 131 (4): 331–7. PMID 26237923.
  41. ↑ Guneyli S, Cinar C, Bozkaya H, Korkmaz M, Oran I (September 2016). “Endovascular management of congenital arteriovenous fistulae in the neck”. Diagn Interv Imaging. 97 (9): 871–5. doi:10.1016/j.diii.2015.08.006. PMID 26972281.
  42. ↑ Gobin YP, Garcia de la Fuente JA, Herbreteau D, Houdart E, Merland JJ (November 1993). “Endovascular treatment of external carotid-jugular fistulae in the parotid region”. Neurosurgery. 33 (5): 812–6. PMID 8264877.
  43. ↑ Madjar S, Weissberg D (July 1995). “Retrosternal goiter”. Chest. 108 (1): 78–82. PMID 7606997.
  44. ↑ Hedayati N, McHenry CR (March 2002). “The clinical presentation and operative management of nodular and diffuse substernal thyroid disease”. Am Surg. 68 (3): 245–51, discussion 251–2. PMID 11893102.
  45. ↑ Hughes K, Eastman C (August 2012). “Goitre – causes, investigation and management”. Aust Fam Physician. 41 (8): 572–6. PMID 23145396.
  46. ↑ Hermus AR, Huysmans DA (August 2000). “[Diagnosis and therapy of patients with euthyroid goiter]”. Ned Tijdschr Geneeskd (in Dutch; Flemish). 144 (34): 1623–7. PMID 10972051.

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