Oligometastatic Parathyroid Carcinoma Presenting as Neck Pain: A Case Report.

Katherine M Yu, Duncan J Trimble, Christopher R Conner, Dallas L Sheinberg, Garren M I Low, Karan Saluja, Karl M Schmitt, Ron J Karni

Ear, nose, & throat journal 2023 Oct

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Parathyroid carcinoma (PC) is an exceedingly rare, slow-growing but progressive endocrine malignancy that represents a diagnostic and therapeutic challenge. Vertebral metastasis of PC is remarkable, with only 3 prior cases of spinal metastasis reported in the literature. A 62-year-old woman presented with 1 week of neck pain radiating down her right arm. Cervical x-ray revealed a lytic lesion of the C4 vertebral body. Lab work revealed hypercalcemia with an elevated parathyroid hormone level. Computed tomography and magnetic resonance imaging revealed frank destruction of the C4 vertebral body and pedicles by PC. She was treated with corpectomy, mass excision, anterior cervical discectomy and fusion, postoperative radiotherapy, and nonspecific inhibitors of active tumor pathways. Her symptoms resolved postoperatively, and she has remained negative for reoccurrence at 15-month follow-up. To the authors' knowledge, we report the first described cervical spine metastasis of PC. Additionally, we review the treatment of this rare neoplasm in an extremely rare location in the age of tumor sequencing and morphoproteomic analysis.

Citation

Katherine M Yu, Duncan J Trimble, Christopher R Conner, Dallas L Sheinberg, Garren M I Low, Karan Saluja, Karl M Schmitt, Ron J Karni. Oligometastatic Parathyroid Carcinoma Presenting as Neck Pain: A Case Report. Ear, nose, & throat journal. 2023 Oct;102(10):635-639