Parathyroid carcinoma is a quite rare disease that presents with severe hyperparathyroidism (Shane, J Clin Endocrinol Metab 2:485-493, 2001). It comprises about 1% of all hyperparathyroidism cases (Cetani et al. Expert Rev Endocrinol Metab 3:377-389, 2008). Typically, carcinomas are > 3 cm in size and PTH levels are in the thousands (Obara and Fujimoto, World J Surg 15:738-744, 1991). Serum Ca level greater than 14 mg/dL and accompanying metabolic bone disease support the diagnosis. Pathological findings may be insufficient to differentiate between parathyroid adenoma and carcinoma (Nayyar et al. Indian J Endocrinol Metab 24:137-142, 2020). Here, a very rare case of parathyroid carcinoma with widespread bodily pain and incidental fracture detected on parathyroid imaging was presented.
