Devastating skeletal effects of delayed diagnosis of complicated primary hyperparathyroidism because of ectopic adenoma.
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.
Souza
Enio Ricardo Vasconcelos
ER
Rheumatology Service of HUGV-UFAM, Federal University of Amazonas, Amazonas, Brazil.
Scrignoli
Juliana Alves
JA
Bezerra
Fabiane Castilho
FC
Ribeiro
Sandra Lúcia Euzébio
SL
Passos
Luiz Fernando de Souza
LF
D000236:Adenoma / Q000150:complications* / Q000473:pathology; D000368:Aged; D001849:Bone Diseases, Endocrine / Q000209:etiology*; D002828:Choristoma; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology; D009397:Nephrocalcinosis / Q000209:etiology; D053040:Nephrolithiasis / Q000209:etiology; D010024:Osteoporosis / Q000209:etiology; D010280:Parathyroid Glands; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000473:pathology; D014133:Tracheal Diseases / Q000209:etiology