How to recognize and treat XXXX .

@entity1 @entity2741 @entity5 @entity4214 @entity460 @entity3 @entity3243
@entity3243 is a rare @entity5 and its clinical course is variable. Differentiation of @entity1 with @entity3243 from those with @entity3243 is often difficult both preoperatively and at operation. For good results, the surgeon must recognize this disorder and perform an en bloc resection at the initial surgery. A neck dissection is necessary only when there is evidence of regional node @entity3 . After surgery, periodic follow-up of the serum @entity460 and iPTH levels is essential. When @entity2741 recurs or the serum iPTH increases, localization studies with the use of @entity4214 -201 scanning help detect local recurrence and regional lymph node @entity3 , but unfortunately, this method often fails to localize pulmonary @entity3 . Chest radiographs and CT scanning are useful for delineating pulmonary @entity3 . A wide excision of locally recurrent @entity5 , an en bloc radical neck dissection and mediastinum dissection for lymphatic @entity3 , and an aggressive surgical resection of lung @entity3 are recommended. Although these operations are rarely curative, they usually offer definite palliation of the marked @entity2741 , often for a considerable period. Drugs to lower the serum @entity460 level and systemic chemotherapy are currently of only limited benefit, and radiation therapy is generally ineffective.
