Multiple osteolysis secondary to primary hyperparathyroidism
Keywords:
parathyroid gland, primary hyperparathyroidism, osteolysis, treatment.Abstract
Introduction: Primary hyperparathyroidism ranks third among endocrine diseases after Diabetes Mellitus and thyroid diseases. It is more frequent in females and in those over 60 years of age, being rare before 15 years of age.
Objective: To describe the clinical, imaging and therapeutic particularities of a patient with multiple osteolysis secondary to primary hyperparathyroidism.
Case Presentation: Female patient, 42 years old, black skin, with a personal pathological history of renal lithiasis and right nephrectomy in 2017 due to lithiasis. She was admitted to the internal medicine service at the “Dr. Carlos J Finlay” hospital for presenting bone pain in the lumbosacral spine and bony pelvis of two years of evolution and vomiting, after being consulted by several specialties. She was found to have osteolytic lesions in the hip, pelvis and lumbar spine, associated with hypercalcemia. Through the determination of parathyroid hormone and parathyroid scintigraphy, the diagnosis of primary hyperparathyroidism secondary to parathyroid adenoma with mediastinal ectopic focus was proposed. Total parathyroidectomy and removal of the ectopic focus were performed. The evolution was satisfactory after surgery.
Conclusions: The finding of hypercalcemia and osteolysis in patients with bone pain orients clinical thinking towards an oncologic profile. However, it must be taken into account that primary hyperparathyroidism may be the cause of such manifestations.
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