Pathological bone fractures in a patient with parathyroid carcinoma - A Case Report.

Parathyroid carcinoma is a rare malignant neoplasm of the parathyroid glands which results in enlargement and excessive production of parathyroid hormone (PTH) responsible for pathologically raising calcium levels in the blood resulting in bone pain/fractures, renal stones and other signs of hypercalcaemia. A 37 year old woman presented with sudden, spontaneous bone pain and fracture of the right femoral shaft. This unusual presentation was explained by extremely high PTH levels and hypercalcaemia in the blood and a hard, solitary mass palpable in the neck. During surgical excision of this mass, finding of several adhesions, possible capsular invasion and lymph node enlargement led to a diagnosis of parathyroid carcinoma. The neoplasm proliferates via adenoma-carcinoma sequence so early diagnosis and prompt surgical excision with post-operative care may provide palliation and keep recurrences in check. Pancreas and pituitary evaluation is also necessary as this presentation may be a part of Wermer (MEN-1) syndrome. .