A parathyroid carcinoma mimicking thyroid carcinoma; A case report

INTRODUCTION AND IMPORTANCE: Parathyroid carcinoma is an extremely rare endocrine neoplasm. Most of the patients present with severe hyperparathyroidism with altered serum calcium levels. CASE PRESENTATION: We describe a patient who presented with a neck mass and secondary hyperparathyroidism Ultrasound (USG) suggested a tumor located near the lower pole of the thyroid gland. USG guided FNAC suggested parathyroid neoplasm. CT scan showed tumor infiltration of the parathyroid gland. The patient underwent total resection of the tumor along with total thyroidectomy and right central compartment clearance. The biopsy of the mass confirmed the parathyroid carcinoma infiltrating the thyroid gland. CLINICAL DISCUSSION: Parathyroid carcinoma is a rare endocrine carcinoma. Due to its location, it is often misdiagnosed as thyroid carcinoma. It can present with problems related to bones, kidney stones, psychiatric problems and many others. Serum calcium, Parathormone level, Ultrasound neck, CT scan and MIBI scan are the imaging study for early diagnosis of Parathyroid carcinoma. Complete removal of tumor followed by regular follow up with serum calcium and Parathormone level will help to improve the survival of Patient. CONCLUSION: Diagnosis of parathyroid carcinoma is very challenging due to the limited contribution of imaging. It mimics thyroid carcinoma due to the origin of the tumor from the lower pole of the thyroid area. It is extremely important for suspicion of parathyroid tumor in case of neck mass who have an abnormality in serum calcium and parathormone level. Total resection of the tumor with a negative margin is important to control hyperparathyroidism and increase the survival.