The Parathyroid carcinoma: a diagnostic challenge before surgery.

Introduction: Parathroid Carcinoma is a rare cause of primary hyperparathyroidism (PPH). His diagnosis is a real challenge. We report an observation and discuss the diagnostic guidelines before surgery.

Case: A 31-year-old Senegalese woman was admitted to our department for the exploration of diffuse bone pain and multiple pathological fractures. Physical examination revealed a right lateral mass of the neck. Serum calcium level was 142.2 mg / l and serum parathyroid hormone 42 N. Ultrasound and cervical tomodensitometry showed a parathyroid mass compressing the thyroid and trachea. The extension assessment revealed osteolytic lesions and T4-T5 epiduritis evoking metastases. Surgery and histology were performed. According to the histopathology and clinical context, the tumor was identified as a parathyroid carcinoma.

Conclusion: The preoperative evaluation of a patient with severe hypercalcemia and high PTH levels should include the possible diagnosis of parathyroid carcinoma, especially in symptomatic patients or in case of palpable neck mass.