A case of parathyroid cancer first revealed by a brown tumor of the mandible

Parathyroid cancer is a rare neoplasm accounting for 0.1% of all Malignancies. There is no validated indication and little experience to guide us in the diagnosis and treatment of this condition that requires a high level of clinical suspicion. The present report concerns a case of parathyroid cancer that primarily manifested through the appearance of a brown tumor of the mandible, a circumstance that up to date has only been described exceptionally. This unusual presentation of an already uncommon medical condition in an otherwise healthy and asymptomatic Woman lead to a delay in diagnosis and to futile investigations. We treated the patient performing radical en-bloc excision of the mass and of the homolateral thyroid lobe. In the absence of clear guidelines and having found no pathological nodes at surgical exploration we decided to refrain from performing a cervical lymphoadenectomy and to put the patient under strict follow-up. Further research, more information and the definition of common rules for management of parathyroid carcinoma are needed to help recognize and treat this rare neoplasm promptly and correctly.