Management of PC. Purple: algorithm title; orange: surgery; dark green: RT; blue: systemic anticancer therapy or their combination; turquoise: non-systemic anticancer therapies or combination of treatment modalities; white: other aspects of management and non-treatment aspects. 5-FU, 5-fluorouracil; ChT, chemotherapy; N+, lymph node metastasis; PC, parathyroid carcinoma; R1, resection with microscopic tumour at the margin; R2, resection with macroscopic tumour at the margin; RT, radiotherapy. aDacarbazine, temozolomide or streptozocin plus 5-FU or capecitabine.