Parathyroid carcinoma: clinical presentation and treatment

Abstract

Carcinoma of the parathyroid gland is a rare cause of primary hyperparathyroidism, with incidence of less than 1%. Parathyroid carcinomas usually grow slowly, with a tendency for local invasion. The preoperative differential diagnosis between carcinoma and adenoma of parathyroid gland is often difficult because many of the signs and symptoms are similar. Patients with parathyroid carcinoma have a generally higher serum calcium level and PTH level, and incidence of renal and bone diseases, pancreatitis, peptic ulcer, and anemia. The most effective therapy for parathyroid cancer is complete resection of the tumor together with the ipsilateral thyroid lobe.We reviewed the case of a 64-year-old woman with parathyroid carcinoma, who had severe hypercalcemia, hypertension, asymptomatic nephrolithiasis, fracture of the neck of the right femur, hypertension, and anemia. A hard mass was palpable on the right side of her neck. The tumor was resected and blocked by the unilateral thyroid lobe. Histopathological examination showed parathyroid carcinoma. The patient was given adjuvant radiation therapy and there was no evidence of recurrence 32 months after surgery.