Microwave Ablation of Pulmonary Metastases from Parathyroid Carcinoma Achieving Normocalcaemia in a Case of Symptomatic Hyperparathyroidism Jaw Tumour Syndrome

Abstract

Parathyroid carcinoma is a rare endocrine malignancy causing less than 1% of cases of primary hyperparathyroidism. It is difficult to treat, with en-bloc resection being the only curative treatment. Recurrence with distant metastases is common, but no standard treatment currently exists beyond surgery. Adjuvant therapies such as chemotherapy and radiotherapy offer little benefit. We present the case of a 63-year-old man with bilateral pulmonary metastases from parathyroid carcinoma that caused hyperparathyroidism with consequent refractory hypercalcaemia. After lung microwave ablation performed on all four pulmonary metastases, the patient remained normocalcaemic with a normal parathyroid hormone level at 13 months’ follow-up. Thermal ablation may offer a long-term palliative option in managing refractory hypercalcaemia in patients with unresectable metastatic parathyroid carcinoma.