ObjectiveTo summarize the experience of comprehensive treatment of parathyroid carcinoma (PTC).MethodThe clinicopathologic data of patient with PTC admitted to the First Affiliated Hospital of Kunming Medical University were retrospectively analyzed.ResultsThe patient was a 42-year-old male, who was diagnosed with the primary hyperparathyroidism after suffering from systemic joint pain for more than 2 years. The patient accepted the first operation in a primary hospital, including the resection of the PTC and ipsilateral thyroid lobectomy, and the PTC was confirmed pathologically. The second operation was performed due to the tumor relapse within thyroid bed. The third operation was performed with the palliative resection of the recurrent tumor in the right neck and the three-dimensional conformal radiation therapy was performed. The fourth operation was performed in the left neck with lateral lymph node dissection of level Ⅲ and level Ⅳ. The lower left lung cuneiform resection was performed in the fifth operation. For the last operation, the mediastinal metastatic tumor was removed with thoracoscopy. The multiple imaging evaluation showed no evidence of recurrence in the neck, but the extensive pulmonary metastasis occurred.ConclusionsSurgery is the only effective treatment for PTC. En bloc excision consists of resection of primary tumor, ipsilateral thyroid lobectomy, other surrounding structures involved by the tumor and central neck dissection. During operation, tumor rupture should be avoided. Accessible metastatic tumor should be resected when possible. Radiotherapy should be performed in patient with local infiltration or unresectable tumor. Effect of chemotherapy for PTC is poor. Supportive medical care should be given for fatal hypercalcemia in patient when treatment failed to control tumor.