Ectopic mediastinal parathyroid carcinoma as a cause of dialysis-dependent renal failure

Carcinoma of the parathyroid gland is infrequent in patients with secondary hyperparathyroidism. Typical clinical symptoms are related to the presence of a neck mass and hypercalcemia. We describe a case of a 55-year-old man in whom primary parathyroid carcinoma led most likely to the development of end-stage dialysis-dependent renal failure, and the diagnosis of the cancer was delayed due to ectopic localization of the tumor, and dramatic complications in the clinical course of the disease, including acute pancreatitis and peritionitis. However, 6 months after successful surgery and subsequent radiotherapy, the patient is well and free from recurrences but remains chronically dialysis-dependent.