RESUMEN
Parathyroid carcinoma (PC) is a rare endocrine malignancy. We report 6 cases of PCs operated on in our department, during a period of 12 years (2010-2021). All of our patients presented severe hyperparathyroidism, high calcium levels, and very elevated parathormone (PTH) rates. Five were between the fifth and sixth decades of life and 1 patient was 37 years old. The parathyroid gland was only palpable in 1 case. All of our patients underwent cervical ultrasound and 5 of them underwent 99m Tc-MIBI scintigraphy. One of the patients presented bilateral parathyroid masses. All our patients were treated surgically: a parathyroidectomy was performed in all cases. In 1 patient, parathyroidectomy was performed in conjunction with a homolateral loboisthmectomy, as the diagnosis of PC was suspected preoperatively due to pulmonary metastases. The final anatomopathological study revealed PC in all cases. Follow-up was uneventful in 5 cases and 1 patient was lost to follow-up. Clinicians should suspect PC in patients with severe hypercalcemia, extremely elevated PTH levels, large parathyroid lesions, and distant metastases. Complete surgical resection, extended to the homolateral thyroid lobe, remains the recommended treatment.
RESUMEN
The metabolic profile during prolactinoma may be subject to significant changes. We aimed to describe the different metabolic aspects in patients monitored for prolactinoma and to study the correlations between the size of the prolactinoma and the metabolic parameters. We conducted a retrospective, descriptive, and analytical study of 77 cases of prolactinomas collected and monitored at the endocrinology and diabetology department of the Hedi Chaker Hospital in Sfax between 2000 and 2017. Our patients were divided into three groups according to the size of their prolactinomas. Statistical correlations were sought between tumor size and clinical and biological parameters. The mean age of our patients was 38.3 ± 14.2 years. They were divided into 51 women (66.2%) and 26 men (33.7%). Pituitary tumor syndrome was the most common circumstance of discovery in our population (62.3%). The clinical examination revealed an average waist circumference of 95.71 cm. Android fat distribution was observed in 25 women (49%) and 12 men (46.1%). A statistically significant positive correlation was objectified between waist circumference and tumor size (r = 0.29 and P = 0.019). The average body mass index was 28.08 kg/m2. Obesity was noted in 56 cases (72.7%). Glucose tolerance disorders and hypertriglyceridemia were also more evident each time prolactinoma size increased in contrast to the level of high-density lipoprotein cholesterol which decreased with adenoma size. Our study highlighted the metabolic and hormonal repercussions of prolactinomas. Metabolic syndrome was more common in patients with larger prolactinoma. These results should guide the initial assessment and therapeutic management of prolactin adenomas.