title: Parathyroid carcinoma with contralateral subcutaneous and breast recurrences: A rare presentation.
abstract: BACKGROUND
  Parathyroid carcinoma is extremely rare. Correct preoperative and even histopathological diagnosis may be difficult owing to the deceptively bland cytoarchitectural features, especially when presenting with localized disease. Recurrence/metastases developing years later then make the malignant nature obvious.
  
  
  RESULTS
  We present here an unusual case of a 32-year-old patient with carcinoma of the left upper parathyroid gland, initially diagnosed as parathyroid adenoma, treated with endoscopic left parathyroidectomy, and later developing subcutaneous metastatic nodules over the medial end of the right clavicle and right anterior chest wall, followed by a right breast deposit. The recurrences, especially subcutaneous ones, were probably secondary to tumor seeding along the track of insertion of the endoscope.
  
  
  CONCLUSIONS
  Involvement of subcutaneous tissue and the breast in parathyroid carcinoma is extremely rare. The case is being reported for its uniqueness along with a discussion of possible appropriate course of management, which may have averted the aggressive clinical course of the disease.
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shipra
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Kumar
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Mehar C
authors.initials: MC
authors.lastname: Sharma
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Nishikant A
authors.initials: NA
authors.lastname: Damle
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ajeet Kumar
authors.initials: AK
authors.lastname: Gandhi
mesh_terms: D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001943:Breast Neoplasms / Q000556:secondary*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010282:Parathyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D016105:Parathyroidectomy; D012878:Skin Neoplasms / Q000556:secondary*
keywords: endoscopic parathyroidectomy; metastases; parathyroid adenoma; parathyroid carcinoma; subcutaneous