title: [Parathyroid carcinoma: clinical case and review of the literature].
abstract: BACKGROUND
  Parathyroid carcinoma is a rare endocrine neoplasm, difficult to define clinically and histopathologically.
  
  
  METHODS
  The case concerns of a 20 years old male with situs viscerum inversus (with dextrocardia), and symptoms: asthenia, oliguresis, nausea, emesis, myalgia, lower limb paresthesia and very high levels of calcium and PTH. Laboratory findings (PTH 580 pg/ml; Ca 12.40 mg/dl; P 1.9 mg/dl), echography, TC, and parathyroid scintigraphy, associated with clinical data, have suggested hypothesis of parathyroid carcinoma confirmed by histological examination and immunochemistry. Surgery was efficacious with normalization of Calcium and PTH levels, and disappearance of symptoms. After two years no signs of local recurrence were present, but imaging show pulmonary micronodulations of uncertain pathological meaning.
  
  
  CONCLUSIONS
  No clinical or bio-humoral data allows a preoperative diagnosis of parathyroid carcinoma. Only with definitive pathology and immunohistochemistry it is possible to differentiate an adenoma from a carcinoma. Surgery is the only effective therapy and therefore should be always performed. This neoplasm usually relapses, locally first and later with distant metastases. For this reason after surgery the patients should always undergo a strict follow-up programme including evaluation of PTH and calcemia.
authors.affiliation: Università degli Studi "La Sapienza", Policlinico Umberto I.
authors.forename: A M
authors.initials: AM
authors.lastname: Romani
authors.forename: A
authors.initials: A
authors.lastname: Panarese
authors.forename: D
authors.initials: D
authors.lastname: Pironi
authors.forename: K P
authors.initials: KP
authors.lastname: Zeri
authors.forename: S
authors.initials: S
authors.lastname: Candioli
authors.forename: A
authors.initials: A
authors.lastname: Manigrasso
authors.forename: A
authors.initials: A
authors.lastname: Filippini
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery