{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:59:39Z","timestamp":1792605579560,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CH"],"published-print":{"date-parts":[[2020,12,22]]},"abstract":"<jats:p>BACKGROUND: Primary hyperparathyroidism (PHPT) results from excessive secretion of parathyroid hormone from parathyroid tumors. Differentiating parathyroid tumors can be challenging before operation. OBJECTIVES: To differentiate parathyroid carcinoma from benign tumors in patients with PHPT by the application of ultrasound and biochemical parameters. METHODS: This study is a retrospective study. The study enrolled 17 patients with parathyroid carcinoma (PC) and 57 patients with parathyroid adenoma (PA), confirmed by postoperative pathology, between September 2010 and July 2017. This study retrospectively compared the ultrasonic features of the tumors included echotexture, maximum lesion diameter, shape, margin, blood flow inside the mass, intralesional calcifications, cysts in the mass, and biochemical parameters included serum calcium, phosphorus, parathyroid hormone (PTH), alkaline phosphatase (ALP) levels, gender distribution and age of patients between patients with PC and those with PA. RESULTS: In the US images, the two groups showed significant differences in heterogeneity, the appearance of a taller-than-wide shape, irregular or lobulated margins, and intralesional calcifications (p\u200a&lt;\u200a#x003C;&lt;\u200a#x200A;0.05). However, no significant difference was found in echogenicity, maximum lesion diameter, blood flow, and cystic components of the mass (p\u200a&gt;\u200a#x003E;&gt;\u200a#x200A;0.05). The mean PTH levels were significantly different between the two groups (p\u200a&lt;\u200a#x003C;&lt;\u200a#x200A;0.05). The PC and PA patients did not differ significantly in terms of mean serum calcium, mean serum phosphorus, and mean ALP levels (p\u200a&gt;\u200a#x003E;&gt;\u200a#x200A;0.05). There were significant differences to distinguish PC from PA in calcifications in mass or\/and taller-than-wide shape combine with PTH\u200a&gt;\u200a#x003E;&gt;\u200a#x200A;1000\u200apg\/mL (p\u200a&lt;\u200a#x003C;&lt;\u200a#x200A;0.05). Significant difference existed in the age between the two groups (p\u200a&lt;\u200a#x003C;&lt;\u200a#x200A;0.001). No significant difference existed in the gender distribution between the two groups (p\u200a&gt;\u200a#x003E;&gt;\u200a#x200A;0.05). CONCLUSION: Ultrasound features especially intralesional calcifications and taller-than-wide shape combine with an extremely high serum PTH (&gt;1000\u200apg\/mL) are helpful in differentiating between benign and parathyroid tumors in patients with PHPT.<\/jats:p>","DOI":"10.3233\/ch-200846","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T11:34:05Z","timestamp":1594899245000},"page":"351-359","source":"Crossref","is-referenced-by-count":8,"title":["Ultrasound combined with biochemical parameters can be used to differentiate parathyroid carcinoma from benign tumors in patients with primary hyperparathyroidism"],"prefix":"10.1177","volume":"76","author":[{"given":"Hui","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiamin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiqing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyu","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/CH-200846_ref1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1590\/2359-3997000000224","article-title":"Evaluation of preoperative ultrasonographic and biochemical features of patients with aggressive parathyroid disease: is there a reliable predictive marker?","volume":"60","author":"Cakir","year":"2016","journal-title":"Archives of Endocrinology and Metabolism"},{"key":"10.3233\/CH-200846_ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000442273","article-title":"Sonography of normal and abnormal thyroid and parathyroid glands","volume":"45","author":"Andrioli","year":"2016","journal-title":"Frontiers of Hormone Research"},{"key":"10.3233\/CH-200846_ref3","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1177\/0284185116666418","article-title":"Differentiation of parathyroid carcinoma and adenoma by preoperative ultrasonography","volume":"58","author":"Nam","year":"2017","journal-title":"Acta Radiologica"},{"key":"10.3233\/CH-200846_ref4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.6061\/clinics\/2015(04)05","article-title":"Is local resection sufficient for parathyroid carcinoma?","volume":"70","author":"Basceken","year":"2015","journal-title":"Clinics"},{"key":"10.3233\/CH-200846_ref5","doi-asserted-by":"crossref","first-page":"398","DOI":"10.15557\/JoU.2015.0037","article-title":"The role of ultrasound and nuclear medicine methods in the preoperative diagnostics of primary hyperparathyroidism","volume":"15","author":"Nieciecki","year":"2015","journal-title":"Journal of Ultrasonography"},{"key":"10.3233\/CH-200846_ref6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11864-011-0171-3","article-title":"Parathyroid carcinoma: update and guidelines for management","volume":"13","author":"Wei","year":"2012","journal-title":"Current Treatment Options in Oncology"},{"key":"10.3233\/CH-200846_ref7","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1530\/EDM-17-0041","article-title":"Giant parathyroid adenoma: Differential aspects compared to parathyroid carcinoma","volume":"2017","author":"Araujo Castro","year":"2017","journal-title":"Endocrinology, Diabetes & Metabolism Case Reports"},{"issue":"Suppl 1","key":"10.3233\/CH-200846_ref8","first-page":"80","article-title":"Parathyroid carcinoma: Diagnosis and clinical implications","volume":"31","author":"Duan","year":"2015","journal-title":"Turk patoloji dergisi"},{"key":"10.3233\/CH-200846_ref9","doi-asserted-by":"crossref","first-page":"3990","DOI":"10.1245\/s10434-015-4672-3","article-title":"Parathyroid carcinoma: An update on treatment outcomes and prognostic factors from the National Cancer Data Base (NCDB)","volume":"22","author":"Asare","year":"2015","journal-title":"Annals of Surgical Oncology"},{"key":"10.3233\/CH-200846_ref10","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s12262-008-0047-3","article-title":"Primary hyperparathyroidism retrospective 10-year study of 32 cases","volume":"70","author":"Shukla","year":"2008","journal-title":"Indian Journalof Surgery"},{"key":"10.3233\/CH-200846_ref11","doi-asserted-by":"crossref","first-page":"e491","DOI":"10.1097\/RLU.0000000000001845","article-title":"Comparative Effectiveness of Ultrasonography, 99mTc-Sestamibi,and 18F-Fluorocholine PET\/CT in Detecting ParathyroidAdenomas in Patients With Primary Hyperparathyroidism","volume":"42","author":"Thanseer","year":"2017","journal-title":"Clin Nucl Med"},{"key":"10.3233\/CH-200846_ref12","doi-asserted-by":"publisher","DOI":"10.3233\/CH-190723"},{"issue":"10","key":"10.3233\/CH-200846_ref13","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1001\/jamasurg.2016.2310","article-title":"The American Association of Endocrine Surgeons guidelines for definitive management of primary hyperparathytoidism","volume":"151","author":"Wilhelm","year":"2016","journal-title":"JAMA Surg"},{"issue":"2","key":"10.3233\/CH-200846_ref14","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/MOO.0000000000000234","article-title":"Parathyroid carcinoma","volume":"24","author":"Goswamy","year":"2016","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"10.3233\/CH-200846_ref15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/cen.13055","article-title":"Preoperative diagnosis and prognosis in 40 parathyroid carcinoma patients","volume":"85","author":"Xue","year":"2016","journal-title":"Clinical Endocrinology"},{"key":"10.3233\/CH-200846_ref16","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1002\/cncy.21888","article-title":"Distinguishing parathyroid and thyroid lesions on ultrasound-guided fine-needle aspiration: A correlation of clinical data, ancillary studies, and molecular analysis","volume":"125","author":"Cho","year":"2017","journal-title":"Cancer Cytopathology"},{"issue":"4","key":"10.3233\/CH-200846_ref17","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.surg.2011.08.010","article-title":"Contrast-enhanced ultrasonography for localization of pathologic glands in patients with primary hyperparathyroidism","volume":"151","author":"Agha","year":"2012","journal-title":"Surgery"},{"issue":"5","key":"10.3233\/CH-200846_ref18","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1210\/jc.2013-1007","article-title":"Highly efficient localization of pathological glands in primary hyperparathyroidism using contrast-enhanced ultrasonography (CEUS) in comparison with conventional ultrasonography","volume":"98","author":"Agha","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"10.3233\/CH-200846_ref19","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3233\/CH-2011-1402","article-title":"Evaluation of the microvascularization of pathologic parathyroid glands in patients with primary hyperparathyroidism using conventional ultrasound and contrast-enhanced ultrasound","volume":"48","author":"Uller","year":"2011","journal-title":"Clin Hemorheol Microcirc"},{"issue":"4","key":"10.3233\/CH-200846_ref20","doi-asserted-by":"crossref","first-page":"423","DOI":"10.3233\/CH-189307","article-title":"VueBox\u00ae perfusion analysis of contrast-enhanced ultrasound (CEUS) examinations in patients with primary hyperparathyroidism for preoperative detection of parathyroid gland adenoma","volume":"70","author":"Platz Batista da Silva","year":"2018","journal-title":"Clin Hemorheol Microcirc"},{"key":"10.3233\/CH-200846_ref21","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s13256-016-1078-1","article-title":"Acute presentation of a giant intrathyroidal parathyroid adenoma: a case report","volume":"10","author":"Rutledge","year":"2016","journal-title":"Journal of Medical Case Reports"},{"key":"10.3233\/CH-200846_ref22","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.jacr.2017.01.046","article-title":"ACR Thyroid Imaging, Reporting and Data System(TI-RADS): White Paper of the ACR TI-RADS Committee","volume":"14","author":"Tessler","year":"2017","journal-title":"Journal of the American College of Radiology"},{"key":"10.3233\/CH-200846_ref23","doi-asserted-by":"crossref","first-page":"9223","DOI":"10.12659\/MSM.911695","article-title":"A prospective study to compare superb microvascular imaging with grayscale ultrasound and color doppler flow imaging of vascular distribution and morphology in thyroid nodules","volume":"24","author":"Yi","year":"2018","journal-title":"Med Sci Monit"},{"key":"10.3233\/CH-200846_ref24","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.nic.2008.03.006","article-title":"Parathyroid imaging","volume":"18","author":"Fakhran","year":"2008","journal-title":"Neuroimaging Clinics of North America"},{"key":"10.3233\/CH-200846_ref25","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.beem.2010.01.003","article-title":"Clinical and molecular genetics of parathyroid neoplasms","volume":"24","author":"Sharretts","year":"2010","journal-title":"Best Practice & Research Clinical Endocrinology & Metabolism"},{"key":"10.3233\/CH-200846_ref26","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1007\/s00423-009-0495-7","article-title":"PTH secretion of \u201cmanipulated\u201d parathyroid adenomas","volume":"394","author":"Riss","year":"2009","journal-title":"Langenbeck\u2019s Archives of Surgery"},{"key":"10.3233\/CH-200846_ref27","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1007\/s00330-011-2141-3","article-title":"Ultrasound features of malignancy in the preoperative diagnosis of parathyroid cancer: a retrospective analysis of parathyroid tumours larger than 15 mm","volume":"21","author":"Sidhu","year":"2011","journal-title":"European Radiology"},{"issue":"4","key":"10.3233\/CH-200846_ref28","first-page":"329","article-title":"Parathyroid cancer","volume":"4","author":"McClenaghan","year":"2015","journal-title":"Gland Surg"},{"key":"10.3233\/CH-200846_ref29","doi-asserted-by":"crossref","first-page":"D1","DOI":"10.1530\/EJE-15-0565","article-title":"Imaging of the parathyroid glands in primary hyperparathyroidism","volume":"174","author":"Salvatore","year":"2016","journal-title":"European Journal of Endocrinoloogy"},{"key":"10.3233\/CH-200846_ref30","doi-asserted-by":"crossref","first-page":"2343","DOI":"10.1007\/s00268-009-9999-0","article-title":"Parathyroid carcinoma etiology, diagnosis, and treatment","volume":"33","author":"Okamoto","year":"2009","journal-title":"World Journal of Surgery"},{"key":"10.3233\/CH-200846_ref31","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/s40618-016-0447-3","article-title":"Update on parathyroid carcinoma","volume":"39","author":"Cetani","year":"2016","journal-title":"Journal of Endocrinological Investigation"},{"key":"10.3233\/CH-200846_ref32","doi-asserted-by":"crossref","first-page":"532","DOI":"10.7150\/jca.2.532","article-title":"Parathyroid carcinoma: Areview with three illustrative cases","volume":"2","author":"Digonnet","year":"2011","journal-title":"Journal of Cancer"}],"container-title":["Clinical Hemorheology and Microcirculation"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/CH-200846","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:04:40Z","timestamp":1777388680000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/CH-200846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,22]]},"references-count":32,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3233\/ch-200846","relation":{},"ISSN":["1386-0291","1875-8622"],"issn-type":[{"value":"1386-0291","type":"print"},{"value":"1875-8622","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,22]]}}}