A Case of Parathyroid Carcinoma

ABSTRACT

Parathyroid carcinoma is a rare disease and its incidence has been reported to be 0.5-5% of all primary hyperparathyroidism cases. Compared to adenoma, parathyroid carcinoma shows higher levels of serum calcium and parathyroid hormone. When there is evidence of generalized bone disease along with the involvement of a neck mass in the hypercalcemic patient, parathyroid carcinoma should not be ruled out. The histological characteristics of malignant cells include nuclear pleomorphism, an increase in Nucleus/ Cytoplasm (N/C) ratio, hyperchromatism, abnormal mitosis and prominent nucleoli. Furthermore, malignat cases involve capsular and vascular invasion as well as metastasesis to the lungs, cervical lymph nodes and bones. The biological behavior of parathyroid carcinoma seems to be variable with a wide range of malignancy. Surgical excision is the first therapeutic option. In this paper, we report and review our experience in a case of parathyroid carcinoma in a 66- year-old female with hypercalcemia, ureteral stones and a neck mass.