{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:32:03Z","timestamp":1791955923055,"version":"4.3.4"},"reference-count":14,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Parathyroid carcinoma (PC) is a rare endocrine malignancy and an uncommon cause of primary hyperparathyroidism. Metastatic disease confers a guarded prognosis with limited systemic treatment options available. We describe a case of a 64-year-old woman with primary hyperparathyroidism secondary to PC. Despite initial surgical resection, the patient relapsed within 6 months with widespread cerebral and skeletal metastatic disease. She developed worsening parathyroid hormone-mediated hypercalcemia that was refractory to escalating doses of cinacalcet and antiresorptive therapy. Molecular genomics identified high tumor mutation burden within the malignant tissue and single-agent nivolumab immunotherapy was administered. After one dose, there was resolution of her refractory hypercalcemia and primary hyperparathyroidism. The patient has tolerated ongoing treatment with 3 weekly cycles of nivolumab. She remains in biochemical remission as of June 2024, which is now 12 months after commencement of nivolumab.<\/jats:p>","DOI":"10.1210\/jcemcr\/luae127","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T06:35:30Z","timestamp":1721025330000},"source":"Crossref","is-referenced-by-count":5,"title":["Refractory Hypercalcemia Secondary to Metastatic Parathyroid Carcinoma Treated With Immunotherapy"],"prefix":"10.1210","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0816-7093","authenticated-orcid":false,"given":"Brenda","family":"Ta","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetes, Prince of Wales Hospital , Randwick 2031 , Australia"},{"name":"Department of Endocrinology and Diabetes, St Vincent's Hospital , Darlinghurst 2010 , Australia"},{"name":"School of Medicine, UNSW , Kensington 2033 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael James","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes, Prince of Wales Hospital , Randwick 2031 , Australia"},{"name":"School of Medicine, UNSW , Kensington 2033 , Australia"},{"name":"Department of Endocrinology, The Sutherland Hospital , Caringbah, NSW 2229 , Australia"},{"name":"The Garvan Institute of Medical Research , Darlinghurst, NSW 2010 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"3","key":"2024072410335866500_luae127-B1","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1002\/(SICI)1097-0142(19990801)86:3<538::AID-CNCR25>3.0.CO;2-K","article-title":"Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985-1995: a National Cancer Data Base Report. The American College of Surgeons Commission on Cancer and the American Cancer Society","volume":"86","author":"Hundahl","year":"1999","journal-title":"Cancer"},{"issue":"7","key":"2024072410335866500_luae127-B2","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1007\/s00423-015-1361-4","article-title":"Evaluation of malignant parathyroid tumours in two European cohorts of patients with sporadic primary hyperparathyroidism","volume":"401","author":"Ozolins","year":"2016","journal-title":"Langenbecks Arch Surg"},{"key":"2024072410335866500_luae127-B3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1159\/000491039","article-title":"Parathyroid carcinoma","volume":"51","author":"Cetani","year":"2019","journal-title":"Front Horm Res"},{"issue":"4","key":"2024072410335866500_luae127-B4","doi-asserted-by":"crossref","first-page":"103843","DOI":"10.1016\/j.amjoto.2023.103843","article-title":"Parathyroid carcinoma: current management and outcomes\u2014a systematic 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scanning","volume":"95","author":"Gardner","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"2024072410335866500_luae127-B8","doi-asserted-by":"crossref","first-page":"997009","DOI":"10.3389\/fonc.2022.997009","article-title":"Treatment and outcome of metastatic parathyroid carcinoma: a systematic review and pooled analysis of published cases","volume":"12","author":"Alberti","year":"2022","journal-title":"Front Oncol"},{"issue":"4","key":"2024072410335866500_luae127-B9","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1507\/endocrj.K09E-283","article-title":"First Japanese patient treated with parathyroid hormone peptide immunization for refractory hypercalcemia caused by metastatic parathyroid carcinoma","volume":"57","author":"Horie","year":"2010","journal-title":"Endocr J"},{"issue":"1","key":"2024072410335866500_luae127-B10","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s12020-019-02136-z","article-title":"Long-term remission of 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