Devastating skeletal effects of delayed diagnosis of complicated primary hyperparathyroidism because of ectopic adenoma

J Clin Rheumatol. 2008 Oct;14(5):281-4. doi: 10.1097/RHU.0b013e31818866ec.

Abstract

Primary hyperparathyroidism is a disease caused by exaggerated secretion of the parathyroid gland hormone, produced by an adenoma in 80% of cases. Ectopic adenomas occur in a small proportion of cases. Herein, the authors report a 72-year-old woman with a delayed diagnosis of primary hyperparathyroidism, produced by an intrathoracic adenoma, with a longstanding course, presenting with severe osteoporosis, multiple fractures, bone deformities, and neurologic impairments. Persistent hypercalcemia, high levels of alkaline phosphatase, and parathyroid hormone were documented and a paratracheal mass was found on a helicoidal tomography of the thorax. After surgical removal, the histopathological examination confirmed an ectopic adenoma of the parathyroid gland and the patient achieved some improvement in her clinical picture.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / complications*
  • Adenoma / pathology
  • Aged
  • Bone Diseases, Endocrine / etiology*
  • Choristoma
  • Female
  • Fractures, Bone / etiology
  • Humans
  • Hypercalcemia / etiology
  • Hyperparathyroidism, Primary / complications*
  • Hyperparathyroidism, Primary / diagnosis*
  • Hyperparathyroidism, Primary / etiology
  • Nephrocalcinosis / etiology
  • Nephrolithiasis / etiology
  • Osteoporosis / etiology
  • Parathyroid Glands
  • Parathyroid Neoplasms / complications*
  • Parathyroid Neoplasms / pathology
  • Tracheal Diseases / etiology