Parathyroid carcinoma in Oman: a 10-year single-center experience and literature review

Background: Parathyroid carcinoma is an exceptionally rare endocrine malignancy with poorly understood pathogenesis due to limited global data. It is often associated with unfavorable outcomes, largely attributable to delayed diagnosis and severe hypercalcemia. Aims and Objectives: To present the clinical, biochemical, radiological, and pathological features of parathyroid carcinoma. Settings: This study was a retrospective chart review conducted at the Endocrine Surgery Unit of the Royal Hospital, Muscat, Oman. Methods: The medical records of all patients with histopathologically confirmed parathyroid carcinoma between January 2012 and December 2023 were examined. Results: Four patients (three males, one female) with a mean age of 49 years were identified. Three patients were presented with symptomatic hypercalcemia, and one was diagnosed incidentally. Preoperative parathyroid hormone (PTH) levels were elevated in all patients, with one exceeding 80 times the upper limit of normal. All patients underwent surgical resection. Postoperative outcomes were favorable with no disease recurrence observed over at least 2 years of follow-up. Conclusion: Parathyroid carcinoma remains a diagnostic challenge due to its rarity and overlapping features with benign disease. A high index of clinical suspicion, supported by significantly elevated PTH and calcium levels, is essential. This report emphasized towards the importance of prompt diagnosis and complete surgical excision in optimizing patient outcomes in the Arab population.