Pathological criteria alone do not make an accurate diagnosis of parathyroid carcinoma in cases of well-defined organ contained lesion without local and distant metastasis. Intra-operative appearance of pale, grayish, firm tumor is highly suggestive of parathyroid carcinoma, even though this finding is not included in the pathological criteria for diagnosing a malignancy. Gross features of the tumor also should be added to the pathological criteria so as to ensure an accurate assessment of the biological behavior of the parathyroid tumor.
Keywords: Adenoma; parathyroid carcinoma; primary hyperparathyroidism.