{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:40:39Z","timestamp":1792197639184,"version":"4.4.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parathyroid carcinoma is a rare endocrine malignancy that remains difficult to distinguish preoperatively from benign causes of primary hyperparathyroidism due to overlapping clinical and biochemical features. This study evaluates the serum parathyroid hormone (PTH)-to-tumor volume ratio as a potential parameter for differentiating parathyroid carcinoma from benign parathyroid lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on 344 patients who underwent surgery for primary hyperparathyroidism between 2017 and 2024. Patients were divided into carcinoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098) and benign lesion groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009336). Clinical, biochemical, and ultrasound-derived tumor volume data were analyzed and compared between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with parathyroid carcinoma had significantly higher PTH levels than those with benign lesions (median, 659 vs. 136.4 pg\/mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and markedly larger tumor volumes (median, 10.14 vs. 0.69\u00a0ml;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Despite higher absolute PTH concentrations, the PTH-to-tumor volume ratio was significantly lower in the carcinoma group (median 89.7 vs. 214.56;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.011). In logistic regression analysis, a lower PTH-to-tumor volume ratio was associated with an increased likelihood of parathyroid carcinoma (OR, 0.990; 95% CI: 0.896\u20130.993;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort, parathyroid carcinoma was characterized by a substantially greater tumor burden and higher circulating PTH concentrations, while the PTH-to-tumor-volume ratio was lower than in benign parathyroid lesions. The observed difference in the ratio is hypothesis-generating and warrants confirmation in larger, multicenter studies. Given the limited number of carcinoma cases, its role in clinical decision-making remains to be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s13304-026-02868-4","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:56:21Z","timestamp":1792194981000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["PTH-to-tumor-volume ratio as a potential exploratory marker in parathyroid carcinoma: a retrospective cohort study"],"prefix":"10.1007","author":[{"given":"Magdalena","family":"Kwapisz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Ga\u0142czy\u0144ski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elwira","family":"Baku\u0142a Zalewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"\u017by\u0142ka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"G\u00f3ralski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Dworakowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Dedecjus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"2868_CR1","doi-asserted-by":"publisher","unstructured":"Viswanath A, Drakou EE, Lajeunesse-Trempe F, Grossman AB, Dimitriadis GK (2025) Parathyroid carcinoma: New insights. 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