title: Synchronous Paget disease of bone and hyperparathyroidism: report of a case with extensive craniofacial involvement.
abstract: Paget disease of bone (PDB) and hyperparathyroidism (HPT) are metabolic osseous disorders which affect ≥2% of the population. As these diseases may share clinical, radiographic, biochemical, and histopathologic features, knowledge of their phenotypic overlap may provide diagnostic utility and improve clinical outcome. Scant information is available in the dental literature regarding patients concurrently affected with both pathologies. We present an unusual case report of a 63-year-old woman coaffected with primary HPT, attributed to a functional oxyphilic parathyroid adenoma, and PDB. Bone scintigraphy revealed pagetoid lesions of the skull, humeral head, spine, sacrum, and hemipelvis. Salient craniofacial features noted were bony involvement of the calvarium and midface, resulting in extensive maxillary overgrowth, hearing loss, telecanthus and consequent visual impairment, nasal deformity, and leontiasis ossea. The patient underwent a partial parathyroidectomy and bisphosphonate administration was to be initiated upon extraction of the remaining dentition.
authors.affiliation: Department of Oncology and Diagnostic Sciences, University of Maryland Dental School, Baltimore, MD 21201-1586, USA. oralpath5@comcast.net
authors.forename: John K
authors.initials: JK
authors.lastname: Brooks
authors.forename: Luis E
authors.initials: LE
authors.lastname: Rivera-Ramirez
authors.forename: Lauren W
authors.initials: LW
authors.lastname: Errington
authors.forename: Mark A
authors.initials: MA
authors.lastname: Scheper
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D015576:Hyperostosis / Q000209:etiology / Q000473:pathology; D006957:Hyperostosis Frontalis Interna / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D006972:Hypertelorism / Q000209:etiology; D008439:Maxillary Diseases / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000209:etiology; D010001:Osteitis Deformans / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000601:surgery; D016105:Parathyroidectomy; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate