Objective:

To present a case of parathyroid carcinoma manifesting as hyperparathyroidism in a young male, emphasizing the need to recognize endocrine causes in patients with unexplained skeletal fragility and pathological fractures.

Key Findings:

• The patient presented with a pathological fracture after minimal trauma, a rare initial manifestation of parathyroid carcinoma.
• Severe hypercalcemia and markedly elevated parathyroid hormone levels were critical in diagnosing primary hyperparathyroidism.
• Imaging studies revealed a suspicious parathyroid tumor, leading to surgical confirmation of parathyroid carcinoma.

Interpretation:

This case underscores the need for clinicians to consider parathyroid carcinoma in young patients presenting with unexplained hypercalcemia and skeletal fragility, as early recognition can facilitate timely diagnosis and management.

Limitations:

• The case is based on a single patient, limiting generalizability and the ability to draw broader conclusions.
• Long-term follow-up data on the patient's recovery and outcomes post-surgery are not provided, which may affect the understanding of treatment efficacy.

Conclusion:

Pathological fractures in young adults should prompt evaluation for endocrine disorders like parathyroid carcinoma, facilitating timely diagnosis and management.