Parathyroid Carcinoma Presenting as Recurrent Primary Hyperparathyroidism and Neck Mass: A Case Report

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Parathyroid carcinoma is a rare endocrine neoplasm, accounting for less than 1% of primary hyperparathyroidism cases.
• Management is challenging due to a high rate of local tumor recurrence.
• This malignancy follows an indolent yet tenacious clinical course.

Purpose of the Study:

• To report a case of recurrent parathyroid carcinoma in a middle-aged North Indian woman.
• To emphasize the difficulties in managing this rare endocrine cancer.
• To highlight the critical factors influencing prognosis and treatment strategies.

Main Methods:

• Case report of a patient with recurrent parathyroid carcinoma.
• Detailed clinical presentation including a palpable neck mass and history of multiple neck dissections.
• Discussion of treatment modalities including surgery, radiotherapy, and chemotherapy.

Main Results:

• The patient presented with recurrent primary hyperparathyroidism and a palpable neck mass.
• She underwent six radical neck dissections.
• External beam radiotherapy was considered for further management.

Conclusions:

• Complete resection during initial surgery is crucial for favorable prognosis in parathyroid carcinoma.
• Chemotherapy and radiotherapy are generally ineffective.
• Aggressive management of hypercalcemia and a multidisciplinary team approach are essential for effective patient care.