Chemotherapy for Metastatic Parathyroid Carcinoma

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Abstract
To the Editor. —In the February Archives Bukowski et al1 reported a complete objective response of pulmonary metastases from parathyroid carcinoma following chemotherapy with fluorouracil, cyclophosphamide, and dacarbazine (imidazole carboxamide). They also stated that "reports of chemotherapy for this neoplasm have appeared, but these attempts have been ineffective." We previously reported2 a case of parathyroid carcinoma with a large mediastinal metastasis and left pleural effusion. That patient was treated with a combination of methotrexate, doxorubicin, cyclophosphamide, and lomustine with complete regression of the mediastinal mass and pleural effusion. The duration of response was 18 months. Our patient did not have hypercalcemia, and that parameter could not be used as a criterion of response. Diagnosis was confirmed, however, by three independent pathologists and by electron microscopy. It is of interest that in our case, as well as in the patient described by Bukowski et al,1 recurrence of parathyroid

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