Lessons learned from a young man with recurrent metastasis parathyroid carcinoma with failed combination treatment

摘要

Parathyroid carcinoma is an extremely rare malignant tumor, composed primarily of vacuolated principal cells, butmay also be composed of eosinophils. The exact etiology and pathogenesis of parathyroid carcinoma is unknown,and head and neck radiation exposure, chronic stimulation from renal failure, and familial syndromes can lead to thedevelopment of parathyroid carcinoma. Most parathyroid carcinoma is difficult to distinguish from benign HPT andis often diagnosed only when there is a recurrence of hypercalcemia several years later, which can manifest as weightloss, extreme fatigue, anorexia, and muscle atrophy. At present, surgical resection remains the primary treatment. Inthis case, the patient underwent initial surgery for primary hyperparathyroidism and was subsequently diagnosedwith parathyroid carcinoma. During the 8 years of follow-up, the patient underwent 7 surgeries in combination withradiation therapy, chemotherapy and targeted medications. Although the neck tumor was cured, the patient died ofcomplications related to hypercalcemia. We will review the literature on the combination of surgery, radiotherapy,chemotherapy, and targeted drug therapy in order to improve the diagnosis and treatment of parathyroid carcinoma.