title: Parathyroid carcinoma: a case series.
abstract: BACKGROUND
  We present 3 patients with parathyroid carcinoma and describe their presentations, clinical profiles, and management.
  
  
  METHODS
  A case series review of medical records.
  
  
  RESULTS
  Two women and 1 man (age range, 32 to 57 years) had parathyroid cancer and primary hyperparathyroidism (PHPT). One patient presented with osteitis fibrosa, 1 with renal stone and a neck mass, and 1 with recurrence of PHPT after excision of supposedly benign parathyroid adenoma 4 years ago. All had severe hypercalcaemia and elevated parathyroid hormone levels that ranged from 4 to 43 times above the normal range. Exploration of the neck clearly identified 1 parathyroid tumour with local invasion; 2 other specimens showed capsular and vascular invasion on frozen section and final histology. All 3 patients underwent parathyroidectomy and ipsilateral hemithyroidectomy. Parathyroid size ranged from 1.3 to 4 cm and no lymph node metastasis was identified. No patient had tumour recurrence after a follow-up period of 1 year.
  
  
  CONCLUSIONS
  Parathyroid carcinoma is a rare endocrine malignancy. Suspicious features include marked hypercalcaemia, neck mass, and local recurrence. Parathyroidectomy with ipsilateral hemithyroidectomy and nodal clearance gives the best chance of reducing local tumour recurrence.
authors.affiliation: Department of Surgery, National University Hospital, Singapore. medcwk@nus.edu.sg
authors.forename: W K
authors.initials: WK
authors.lastname: Cheah
authors.forename: A
authors.initials: A
authors.lastname: Rauff
authors.forename: K O
authors.initials: KO
authors.lastname: Lee
authors.forename: W
authors.initials: W
authors.lastname: Tan
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis*; D006961:Hyperparathyroidism / Q000175:diagnosis*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome