title: Devastating skeletal effects of delayed diagnosis of complicated primary hyperparathyroidism because of ectopic adenoma.
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.
authors.affiliation: Rheumatology Service of HUGV-UFAM, Federal University of Amazonas, Amazonas, Brazil.
authors.forename: Enio Ricardo Vasconcelos
authors.initials: ER
authors.lastname: Souza
authors.forename: Juliana Alves
authors.initials: JA
authors.lastname: Scrignoli
authors.forename: Fabiane Castilho
authors.initials: FC
authors.lastname: Bezerra
authors.forename: Sandra Lúcia Euzébio
authors.initials: SL
authors.lastname: Ribeiro
authors.forename: Luiz Fernando de Souza
authors.initials: LF
authors.lastname: Passos
mesh_terms: 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