title: Parathyroid carcinoma presenting with pathologic fracture: case report and review of the literature.
abstract: BACKGROUND
  Parathyroid carcinoma is a rare neoplasm representing <1% of primary hyperparathyroidism cases. It is often not diagnosed until surgical exploration as a preoperative diagnosis is often not possible. Thus, preoperative staging for most patients is not feasible and this may compromise the treatment strategy.
  
  
  RESULTS
  We report a case of a 29-year-old man presenting with avulsion fracture of the right elbow after a trivial fall. Neck exploration revealed an enlarged left lobe focally adherent to the larynx and trachea. Final pathology revealed parathyroid carcinoma with focally positive margin at the site of tracheal invasion.
  
  
  CONCLUSIONS
  Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. The etiology of parathyroid carcinoma is usually obscured, and the initial operation offers the best chance for cure.
authors.affiliation: ENT Associates of South Atlanta, Atlanta, Georgia.|Department of Surgery, Atlanta Medical Center, Atlanta, Georgia.
authors.forename: James K
authors.initials: JK
authors.lastname: Fortson
authors.affiliation: ENT Associates of South Atlanta, Atlanta, Georgia.
authors.forename: Roger
authors.identifier: http://orcid.org/0000-0001-7934-6183
authors.initials: R
authors.lastname: Su
authors.affiliation: Department of Surgery, Atlanta Medical Center, Atlanta, Georgia.
authors.forename: Vijaykumar G
authors.initials: VG
authors.lastname: Patel
authors.affiliation: Department of Pediatric ENT, Spanish Town Hospital, Jamaica, West Indies.
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Lawrence
mesh_terms: D000058:Accidental Falls; D000328:Adult; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: carcinoma; case report; fracture; parathyroid; pathological