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.