{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:11:56Z","timestamp":1787062316058,"version":"build-2736575974"},"reference-count":50,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Parathyroid cancer (PC) is a rare sporadic or hereditary malignancy whose histologic features were redefined with the 2022 WHO classification. A total of 24 Italian institutions designed this multicenter study to specify PC incidence, describe its clinical, functional, and imaging characteristics and improve its differentiation from the atypical parathyroid tumour (APT). Methods: All relevant information was collected about PC and APT patients treated between 2009 and 2021. Results: Among 8361 parathyroidectomies, 351 patients (mean age 59.0 \u00b1 14.5; F = 210, 59.8%) were divided into the APT (n = 226, 2.8%) and PC group (n = 125, 1.5%). PC showed significantly higher rates (p &lt; 0.05) of bone involvement, abdominal, and neurological symptoms than APT (48.8% vs. 35.0%, 17.6% vs. 7.1%, 13.6% vs. 5.3%, respectively). Ultrasound (US) diameter &gt;3 cm (30.9% vs. 19.3%, p = 0.049) was significantly more common in the PC. A significantly higher frequency of local recurrences was observed in the PC (8.0% vs. 2.7%, p = 0.022). Mortality due to consequences of cancer or uncontrolled hyperparathyroidism was 3.3%. Conclusions: Symptomatic hyperparathyroidism, high PTH and albumin-corrected serum calcium values, and a US diameter &gt;3 cm may be considered features differentiating PC from APT. 2022 WHO criteria did not impact the diagnosis.<\/jats:p>","DOI":"10.3390\/jcm12196297","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T07:42:08Z","timestamp":1695973328000},"page":"6297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Parathyroid Retrospective Analysis of Neoplasms Incidence (pTRANI Study): An Italian Multicenter Study on Parathyroid Carcinoma and Atypical Parathyroid Tumour"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-5831","authenticated-orcid":false,"given":"Angela","family":"Gurrado","sequence":"first","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University Medical School of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-2383","authenticated-orcid":false,"given":"Alessandro","family":"Pasculli","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University Medical School of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Avenia","sequence":"additional","affiliation":[{"name":"General and Endocrine Surgery Unit, S. Maria University Hospital, University of Perugia, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Bellantone","sequence":"additional","affiliation":[{"name":"Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Boniardi","sequence":"additional","affiliation":[{"name":"General Oncology and Mini-Invasive Surgery Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Merante Boschin","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35143 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9637-1145","authenticated-orcid":false,"given":"Pietro Giorgio","family":"Cal\u00f2","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Camandona","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Molinette Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-2295","authenticated-orcid":false,"given":"Giuseppe","family":"Cavallaro","sequence":"additional","affiliation":[{"name":"Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-8693","authenticated-orcid":false,"given":"Fabio","family":"Cianchi","sequence":"additional","affiliation":[{"name":"Digestive Surgery Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Conzo","sequence":"additional","affiliation":[{"name":"Division of General, Oncological, Mini-Invasive and Obesity Surgery, Department of Medical and Traslational Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"De Crea","sequence":"additional","affiliation":[{"name":"UOC Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"},{"name":"Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell\u2019Obesit\u00e0, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"De Pasquale","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Department, San Paolo Hospital, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6776-5441","authenticated-orcid":false,"given":"Paolo","family":"Del Rio","sequence":"additional","affiliation":[{"name":"Department of General and Specialist Surgery, Parma University Hospital, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7012-8654","authenticated-orcid":false,"given":"Giovanna","family":"Di Meo","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University Medical School of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianlorenzo","family":"Dionigi","sequence":"additional","affiliation":[{"name":"Division of Surgery, Istituto Auxologico Italiano IRCCS, 20122 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Dobrinja","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Sciences, University of Trieste, 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Docimo","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9017-1991","authenticated-orcid":false,"given":"Fausto","family":"Fam\u00e0","sequence":"additional","affiliation":[{"name":"Department of Human Pathology in Adulthood and Childhood \u201cG. Barresi\u201d, University Hospital \u201cG. 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6057-4642","authenticated-orcid":false,"given":"Maurizio","family":"Iacobone","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35143 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Innaro","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Surgery, AOU \u201cDulbecco\u201d, University \u201cMagna Graecia\u201d of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celestino Pio","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Materazzi","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University Hospital of Pisa, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9546-0178","authenticated-orcid":false,"given":"Fabio","family":"Medas","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Mullineris","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Emergency and New Technologies, Modena Hospital, 41126 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2528-2708","authenticated-orcid":false,"given":"Luigi","family":"Oragano","sequence":"additional","affiliation":[{"name":"Surgical Unit of General Surgery, \u201cSan Biagio\u201d Hospital, 28845 Domodossola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Palestini","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, Fondazione Piemontese per l\u2019Oncologia, 10060 Candiolo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2271-5766","authenticated-orcid":false,"given":"Giuliano","family":"Perigli","sequence":"additional","affiliation":[{"name":"Digestive Surgery Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, 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Italy"},{"name":"Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell\u2019Obesit\u00e0, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Renzulli","sequence":"additional","affiliation":[{"name":"Unit of Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University Medical School of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lodovico","family":"Rosato","sequence":"additional","affiliation":[{"name":"Department of Surgery-ASL TO4, Ivrea Hospital, 10015 Ivrea, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregorio","family":"Scerrino","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6087-4119","authenticated-orcid":false,"given":"Lucia Ilaria","family":"Sgaramella","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University Medical School of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0427-6648","authenticated-orcid":false,"given":"Salvatore","family":"Sorrenti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Testini","sequence":"additional","affiliation":[{"name":"Digestive Surgery Unit, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2780-6421","authenticated-orcid":false,"given":"Massimiliano","family":"Veroux","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Gasparri","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Molinette Hospital, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9297-4894","authenticated-orcid":false,"given":"Mario","family":"Testini","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University Medical School of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"pTRANI Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102012","DOI":"10.1016\/j.ctrv.2020.102012","article-title":"Parathyroid cancer: An update","volume":"86","author":"Rodrigo","year":"2020","journal-title":"Cancer Treat. 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