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The patient underwent parathyroidectomy with ipsilateral hemithyroidectomy without postoperative complications. Microscopic examination showed a parathyroid neoplasm with fibrosis and intravascular tumour on a background of unremarkable thyroid parenchyma. This resulted in an initial impression of parathyroid carcinoma. Further review by two independent pathologists provided a final diagnosis of oncocytic parathyroid adenoma. This case highlights the subjectivity and interobserver variation with endocrine histological examination. FNA can induce changes that mimic parathyroid carcinoma on histology. An index of suspicion for benign parathyroid adenomas should be maintained.<\/jats:p>","DOI":"10.1136\/bcr-2019-231373","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T05:05:30Z","timestamp":1567746330000},"page":"e231373","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Atypical presentation of oncocytic parathyroid adenoma masquerading as metastatic carcinoma"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4443-7736","authenticated-orcid":false,"given":"Suha","family":"Abdulla","sequence":"first","affiliation":[{"name":"School of Medical Education, King\u2019s College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eamon","family":"Shamil","sequence":"additional","affiliation":[{"name":"Department of ENT Surgery, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Wilsher","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of ENT Surgery, University Hospital Lewisham, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,5]]},"reference":[{"key":"2025082803570462000_12.9.e231373.1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/BF02819737","article-title":"Parastruma maligna aberrata","volume":"100","author":"Quervain","year":"1909","journal-title":"Deutsche Zeitschrift f\u00fcr Chirurgie"},{"key":"2025082803570462000_12.9.e231373.2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19990801)86:3<538::AID-CNCR25>3.0.CO;2-K"},{"key":"2025082803570462000_12.9.e231373.3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.2.485"},{"key":"2025082803570462000_12.9.e231373.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.10.005"},{"key":"2025082803570462000_12.9.e231373.5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1571"},{"key":"2025082803570462000_12.9.e231373.6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2003.01814.x"},{"key":"2025082803570462000_12.9.e231373.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199403173301105"},{"key":"2025082803570462000_12.9.e231373.8","doi-asserted-by":"publisher","DOI":"10.1210\/jc.78.6.1320"},{"key":"2025082803570462000_12.9.e231373.9","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0717"},{"key":"2025082803570462000_12.9.e231373.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa031237"},{"key":"2025082803570462000_12.9.e231373.11","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-013-9294-3"},{"key":"2025082803570462000_12.9.e231373.12","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2003.01168.x"},{"key":"2025082803570462000_12.9.e231373.13","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1997.3421147.x"},{"key":"2025082803570462000_12.9.e231373.14","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1111\/cen.12714","article-title":"Prevalence of parathyroid carcinoma in 348 patients with multiple endocrine neoplasia type 1 - 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