Parathyroid Carcinoma: One Case of Multiple Metastases

A 27-year-old man complained discontinuous nausea and vomit. He had a disease course spanning over 2 years, during which he had a sever weight loss (about 30kg). A diagnosis of gastric retention was made at the first visit. At the second time he was treated as anemia, hypoproteinemia and kidney stone. This time with resection of the goiter at the right chest, the patient was in remission of the symptoms of nausea and vomit for about half a year. A road accident resulted in the fracture (Fig.1a) of left tibiofibula and ulna. The fracture of both femur was established 4 months later, and then a diagnosis of severe primary hyperparathyroidism had finally been established based on the high levels of serum calcium and intact parathyroid hormone. The patient underwent surgical exploration, presenting unchanged serum calcium and PTH concentrations. The 18F-Fluorocholine PET-CT detected multiple pathological metastatic carcinoma of bone. Postop-eratively, the patient choosed to continue treatment under the nurse of his family. After five month of follow-up, we received the message of death from a relative of our patient. Our case showing details below, is characterized by perplexing clinical expression and a challenge in the management of parathyroid carcinoma.