title: Primary hyperparathyroidism-jaw tumor syndrome: a confusing and forgotten diagnosis.
abstract: BACKGROUND
  Primary hyperparathyroidism is caused by the excessive growth of parathormone secretion, its consequence being hypercalcemia. The parathyroid adenoma is responsible for over half of primary hyperparathyroidism cases. The mandibular tumor can be the initial sign in the case of primary hyperparathyroidism.
  
  
  METHODS
  We present the case of a 33 year old patient with history of a mandibular operated tumor, repetitive pathological fractures and hypercalcemia manifestations. The level of the parathormone at the first measurement indicated a very high value. The parathyroid scintigraphy with 99mTc-MIBI (methoxy-isobutyl-isonitrile) evidenced a high uptake of the tracerin the superior mediastinum, suggestive for an ectopic parathyroid adenoma. The histopathological examination after surgery leads to the diagnosis of parathyroid adenoma. The association between the primary hyperparathyroidism, the mandibular tumour, the clinical history and the nuclear imaging lead to the diagnosis of primary hyperparathyroidism - Jaw tumor syndrome.
  
  
  CONCLUSIONS
  The hyperparathyroidism - Jaw tumor syndrome has a special clinical importance because of the severe and progressive symptomatology, and because of the risk of developing neoplasia of parathyroid glands, which have a reserved prognosis.
authors.affiliation: Department of Nuclear Medicine and Endocrinology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania; Department of Nuclear Medicine and Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Doina
authors.initials: D
authors.lastname: Piciu
authors.affiliation: Department of Medical Oncology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania; Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Andra
authors.initials: A
authors.lastname: Piciu
authors.affiliation: Department of Nuclear Medicine and Radiotherapy, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania; Department of Nuclear Medicine and Radiotherapy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Elena
authors.initials: E
authors.lastname: Barbus
authors.affiliation: Department of Nuclear Medicine, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania; Department of Nuclear Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Claudiu
authors.initials: C
authors.lastname: Pestean
authors.affiliation: Department of Nuclear Medicine, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania; Department of Nuclear Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Maria Iulia
authors.initials: MI
authors.lastname: Larg
authors.affiliation: Department of Pathology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Fetica
keywords: 99m Tc-MIBI; bone scan; jaw tumor; primary hyperparathyroidism