Hyperparathyroidism-jaw tumor syndrome: Results of operative management

Amit Mehta, Dhaval Patel, Avi Rosenberg, Myriem Boufraqech, Ryan J. Ellis, Naris Nilubol, Martha M. Quezado, Stephen J. Marx, William F. Simonds, Electron Kebebew

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Hyperparathyroidism-jaw tumor syndrome (HPT-JT) is a rare, autosomal-dominant disease secondary to germline-inactivating mutations of the tumor suppressor geneHRPT2/CDC73.Theaimof the present study was to determine the optimal operative approach to parathyroid disease in patientswithHPT-JT. Methods. A retrospective analysis of clinical and genetic features, parathyroid operative outcomes, and disease outcomes in 7 unrelated HPT-JT families. Results. Seven families had 5 distinct germline HRPT2/CDC73 mutations. Sixteen affected family members (median age, 30.7 years) were diagnosed with primary hyperparathyroidism (PHPT). Fifteen of the 16 patients underwent preoperative tumor localization studies and uncomplicated bilateral neck exploration at initial operation; all were in biochemical remission at most recent follow-up. Of these patients, 31% had multiglandular involvement; 37.5% of the patients developed parathyroid carcinoma (median overall survival, 8.9 years; median follow-up, 7.4 years). Long-term follow-up showed that 20% of patients had recurrent PHPT. Conclusion. Given the high risk of malignancy and multiglandular involvement in our cohort, we recommend bilateral neck exploration and en bloc resection of parathyroid tumors suspicious for cancer and life-long postoperative follow-up.

Original languageEnglish (US)
Pages (from-to)1315-1325
Number of pages11
JournalSurgery (United States)
Volume156
Issue number6
DOIs
StatePublished - 2014

ASJC Scopus subject areas

  • Surgery

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