OBJECTIVES: To  present  a  rare  case  of  primary  parathyroid  carcinoma  and  discuss  its  clinical findings and management.
METHODS:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
RESULTS: A 54-year-old woman presented with a 3-year history of recurrent nephrolithiasis despite several  courses  of  shock  wave  lithotripsy.  She  had  persistent  hypercalcemia  and  parathyroid hormone levels were noted to be elevated. Neck ultrasound showed a hypoechoic solid nodule measuring  approximately  1.7  x  1.6  cm  in  the  lateral  inferoposterior  aspect  of  the  left  thyroid lobe. Parathyroid scintigraphy revealed a focal uptake on the left lower thyroidal bed. The patient underwent  left  inferior  parathyroidectomy  with  subtotal  thyroidectomy  and  isthmusectomy Frozen  section  reported  a  parathyroid  tumor  and  the  final  histopathologic  results  revealed  a parathyroid carcinoma.
CONCLUSION: A  rare  case  of  parathyroid  carcinoma  was  presented  manifesting  with  recurrent nephrolithiasis.  Elevated  serum  calcium  and  intact  parathyroid  hormone  (iPTH)  can  confirm  a primary  hyperparathyroid  problem.  Neck  ultrasound  and  parathyroid  scintigraphy  help  in  the localization of a parathyroid tumor. Only final histopathologic results can confirm the diagnosis of parathyroid carcinoma. Complete surgical excision is the treatment of choice and offers a good prognosis.