Parathyroid Carcinoma Masquerading as Adenoma

Although parathyroid neoplasms are common and cause primary hyperparathyroidism (PTH), parathyroid carcinoma (PC) is a rare entity. At times, it can be difcult to diagnose, and it is commonly made after surgery. However, there are some clinical/biochemical features that should raise suspicion of parathyroid carcinoma, namely markedly elevated serum calcium and parathyroid hormone levels and a large parathyroid lesion with suspected ultrasonographic features of malignancy, that damages the kidney and bones. Rather than the tumor spreading, the majority of the clinical characteristics are caused by the impact of increased PTH secretion. It is not always simple to distinguish between parathyroid cancer and adenoma; nevertheless, even in typical situations, these features can mislead the practitioner and have a negative effect on treatment strategies and approaches. Patients will not get the best chance of recovery if a less-than-optimal method is taken. The best chance of cure is the complete surgical resection with the en-bloc excision at the initial operation, and they have a lower recurrence rate with a survival rate as high as 90% at 5 years and 67% at 10 years. Unfortunately, many patients do not receive a full resection, and a large percentage do not receive a diagnosis at the time of initial surgery. We are reporting a rare case of parathyroid carcinoma, highlighting the diagnostic challenges.