title: Delayed diagnosis of primary hyperparathyroidism in a patient with osteoclastoma.
abstract: Primary hyperparathyroidism (HPTo) nowadays is most often recognized incidentally in the asymptomatic period as a result of biochemical screening or evaluation of low bone mass. Classical manifestations of the disease are present in about 15-20% of patients.   We present the case of a 28-year-old male patient who had been treated for two years for osteoclastoma of the proximal tibia, first by intralesional curettage with cement filling followed by bone grafting, and finally with a reconstructive arthroplasty of the knee joint. The patient had been consulted in different medical centers by at least 14 doctors representing 9 different specialties, but the correct diagnosis of HPTo had not been made, although classic  manifestations of the disease had been present for 5-6 years. This suggests that a diagnosis of HPTo  is difficult nowadays. Therefore, determination of serum calcium concentration and other markers of calcium and phosphate metabolism should be obligatory in patients with bone lesions.
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Karol Marcinkowski University of Medical Sciences, Poznań, Poland. dbblaszyk@ump.edu.pl
authors.forename: Daria
authors.initials: D
authors.lastname: Baszko-Błaszyk
authors.forename: Maciej
authors.initials: M
authors.lastname: Biczysko
authors.forename: Paweł
authors.initials: P
authors.lastname: Gut
authors.forename: Ryszard
authors.initials: R
authors.lastname: Waśko
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sowiński
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D001862:Bone Resorption / Q000175:diagnosis / Q000209:etiology*; D002118:Calcium / Q000097:blood; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D008297:Male
chemical_list: D015415:Biomarkers; D002118:Calcium