Pathological fractures in primary hyperparathyroidism

Morgan, Guilherme José; Ganapathi, M.; Afzal, Sina; Grant, Alison

doi:10.1016/s0020-1383(01)00134-6

Cited by 17 publications

(10 citation statements)

References 2 publications

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“…Some large bone defects increase the risk of spontaneous fracture, a rare complication of PHPT. The reported crude fracture rate in patients with PHPT has been documented as 15 per 1000 person-years (compared with 8 per 1000 in controls) [ 32 ]. However, PHPT revealed by pathological fracture, as in our third patient, is extremely rare [ 24 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of primary hyperparathyroidism: report of three cases

et al. 2015

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BackgroundPrimary hyperparathyroidism is an endocrinopathic condition characterized by hypersecretion of parathyroid hormone. Excess parathyroid hormone results in an altered state of osseous metabolism involving bone resorption and tissue change known as osteitis fibrosa cystica, which is the end stage of primary hyperparathyroidism. Osteitis fibrosa cystica is associated with the development of brown tumors, which are rare because hyperparathyroidism is now usually diagnosed and treated before symptoms develop. Brown tumors are rarely the first symptom of hyperparathyroidism and can occasionally be mistaken for malignancy.Case PresentationWe herein report three cases of primary hyperparathyroidism with an unusual presentation of brown tumors. All three patients were Asian. In the first case, a 42-year-old man was admitted with a mass mimicking a malignant bone neoplasm in the right mandible as the first manifestation of primary hyperparathyroidism. The second case involved a 25-year-old man admitted with a fracture of his right femur. The third case involved a 43-year-old man with multiple brown tumors in both lower limbs. All three patients underwent successful parathyroidectomy for parathyroid adenomas; one case was complicated by a papillary thyroid carcinoma.ConclusionComplete evaluation of the medical history and biochemical and radiographic findings is necessary to achieve a correct diagnosis and avoid unnecessary bone resections in patients with primary hyperparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Unusual presentation of primary hyperparathyroidism: report of three cases

et al. 2015

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“…The crude fracture rate in patients known to have PHPT has been documented at 15/1000 person years compared to 8/1000 in controls [2]. However, PHPT revealed by pathological fracture, as in our case, is very uncommon [1–4]. Our patient had a history of falling, and considering her age, osteoporosis was probably associated to some extent.…”

Section: Discussionmentioning

confidence: 57%

“…Up to one third of patients may be asymptomatic. Bone pain and tenderness are seen in PHPT but occur more commonly in secondary hyperparathyroidism [1]. Very rarely, fracture occurs in HPT.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Presentation of Primary Hyperparathyroidism: Pathological Fracture

Khaoula

Kaouther

Chelly

et al. 2011

Case Reports in Orthopedics

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Primary hyperparathyroidism revealed by a pathological fracture is very uncommon. We present a case of a 54-year-old female patient who was admitted with fracture of her right femur. She underwent closed intramedullary reconstruction nailing with bipolar locking. The pathological findings confirmed the diagnosis of primary hyperparathyroidism with brown tumor. Further tests showed increased both calcium level and PTH level. A parathyroidectomy was performed. She made an uneventful recovery and was discharged to home.

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“…pHPT is present in about 1% of the adult population. The incidence of the disease increases to 2% or higher after age 55 and is 2 to 3 times more common in women than in men [5, 6]. In approximately 80–85% of cases with primary hyperparathyroidism, a single adenoma is found [2, 5].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of the disease increases to 2% or higher after age 55 and is 2 to 3 times more common in women than in men [5, 6]. In approximately 80–85% of cases with primary hyperparathyroidism, a single adenoma is found [2, 5]. Multiple gland hyperplasia or neoplasia is present in the 15% remaining [4, 7, 8].…”

Section: Introductionmentioning

confidence: 99%

Pathologic Fractures: A Neglected Clinical Feature of Parathyroid Adenoma

Abshirini

Rashidi

Saki

2010

Case Reports in Medicine

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The pattern of clinical presentation of primary hyperparathyroidism (pHPT) has changed dramatically from a severe disease to an asymptomatic condition in Western countries. The story is completely different in Eastern countries. Bone and joint related sign and symptoms like bone pain and multiple fractures are common in these patients. Imaging and nuclear medicine studies will be helpful specially in patient who candidate for surgical removal of the abnormal parathyroid gland. Here, we present a 48-year-old man with multiple typical fractures in long bones and a single adenoma in his right inferior parathyroid gland. pHPT is a severe, symptomatic disease with serious complications and high morbidity in Iran. Advanced skeletal disease is the most common pattern of presentation.

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Pathological fractures in primary hyperparathyroidism

Cited by 17 publications

References 2 publications

Unusual presentation of primary hyperparathyroidism: report of three cases

Unusual presentation of primary hyperparathyroidism: report of three cases

An Unusual Presentation of Primary Hyperparathyroidism: Pathological Fracture

Pathologic Fractures: A Neglected Clinical Feature of Parathyroid Adenoma

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