Parathyroid carcinoma presenting as severe hypercalcaemia responding to steroids

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Primary hyperparathyroidism is a common endocrine disorder often managed with parathyroidectomy.
• Severe or symptomatic hypercalcemia requires prompt medical and surgical intervention.
• The COVID-19 pandemic caused significant delays in elective surgical procedures, impacting patient management.

Observation:

• A male patient in his 50s presented with profound, symptomatic hypercalcemia due to primary hyperparathyroidism.
• His condition was refractory to multiple medical treatments and delayed parathyroidectomy.
• Intravenous steroid administration led to normalization of serum calcium levels.

Findings:

• Histopathological examination post-parathyroidectomy confirmed parathyroid carcinoma.
• The patient's hypercalcemia resolved with steroids and surgical intervention.
• This case demonstrates an unusual presentation of parathyroid cancer.

Implications:

• Steroid responsiveness in primary hyperparathyroidism may indicate underlying parathyroid malignancy.
• Consideration of parathyroid carcinoma is crucial in refractory hypercalcemia cases.
• Multidisciplinary management is essential for complex endocrine surgical cases, especially during public health crises.