甲状旁腺癌是一种罕见的恶性肿瘤。病人常出现典型的骨、肾病变，可有血钙和甲状旁腺激素的明显升高，70%的病人可扪及甲状旁腺肿瘤。影像学检查多可明确定位，但难以鉴别性质。冰冻病理对甲状旁腺癌诊断价值有限，而标本大体外观却非常特异。肿瘤易复发，首次手术中整块地根治性切除肿瘤病灶是降低复发率、改善预后的关键因素。一旦复发，应努力明确转移部位和扩散范围，争取再次切除病灶，药物控制高钙血症，改善病人生存质量，延长生存期。

Parathyroid carcinoma: Challenge and reply        CHEN Xi. Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine，Shanghai200025, China
Abstract    Parathyroid carcinoma is a rare endocrine malignancy. Most patients will present with signs and symptoms of severe hypercalcaemia and elevated parathyroid hormone, such as bone and kidney lesions. Up to 70% of patients present with a palpable neck mass. Imaging studies can localize most of the tumors, but are hard to identify character. Frozen pathologic study has poor value in diagnosis of parathyroid carcinoma, which often has a specific appearance. A significant proportion of patients will experience recurrence. However, complete en-bloc resection of the tumor in initial surgery offers the best chance for cure. Once recuurrence occurred , metastatic location and scale should be indentified. Reoperation should be performed. Medical management should be performed to control hypercalcaemia and improve quality of life and prolong survival.