Parathyroid carcinoma: Two unique cases detailing multi-disciplinary management

Parathyroid carcinoma is a rare form of cancer, which can be initially a diagnostic challenge and once diagnosed, there is lack of clinical evidence for its management. Its predominant manifestation is symptomatic hypercalcemia, but incidental diagnoses can also occur. Here, we report two cases but each with its own clinical nuances-one presents with asymptomatic hypercalcemia and the other presents with long-standing debilitating manifestations of hypercalcemia. We detail our extensive pre-operative evaluation and the perioperative management. Both are treated surgically, requiring radical excision, and both had unilateral level VI neck dissections. Radiological and biochemical surveillance is performed in both cases and in each case is essential in long-term management. Both patients remain disease free on one-year postoperative follow-up.