Abstract

Parathyroid carcinoma is a rare endocrine tumor which can be characterized with severe hypercalcemia. Fluid replacement, diuretic therapy, bisphosphonates and calcimimetic agents are the main steps of the treatment in control of life-threatening hypercalcemia. There is limited information about the use of denosumab in repeated and refractory hypercalcemia associated with parathyroid carcinoma. In this case report, we discussed the use of denosumab and other treatment approaches for a 44-year-old male patient diagnosed with parathyroid carcinoma who has a history of kidney stones, resistant and recurrent hypercalcemia. Normocalcemia could not be achieved at follow-up after parathyroidectomy in the patient but rapid reduction of calcium was observed after the injection of denosumab. Denosumab may be considered as an alternative treatment agent with rapid efficiency in patients with severe hypercalcemia and parathyroid carcinoma.