Pathologic fractures in the course of a primary hyperparathyroidism
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Scientific Society of Students, Medical University, Lublin, Poland
Department of Internal Medicine, Medical University, Lublin, Poland
Department of Radiology, Medical University, Lublin, Poland
Department of Histopathology, Medical University, Lublin, Poland
Corresponding author
Arun Prashar   

Department of Internal Medicine, Medical University, Staszica 11, 20-081 Lublin, Poland.
J Pre Clin Clin Res. 2012;6(1):64-67
A 49-year-old patient initially presented to the hospital with fractures seemingly suffered from relatively minor trauma. Imaging and laboratory tests showed abnormalities consistent with dysfunctional mineralization of bone. Computed tomography revealed a mass localized in the inferior parathyroid glands that was removed during a subtotal parathyroidectomy. Follow-up with histopathological studies determined the mass to be a parathyroid adenoma; subsequently, the diagnosis of osteitis fibrosa cystica as a sequela of advanced primary hyperparathyroidism was ascertained. The presented report discusses an extremely severe/advanced case of primary hyperparathyroidism that caused extensive bone demineralization in which several pathologic fractures occurred.
Lewis JL, Daly PA, Landsberg L. The Merck Manual of Medicine. 19th rev. ed. Whitehouse Station (NJ): Merck & Co., Inc. 2011; 837-54: 909-14.
Fang SH, Lal G. Parathyroid Cancer. Endocrine Practice. 2011; 17(1S): 36-43.
Ceroni D, Martin X, Delhumeau C, Rizzoli R, Kaelin A, Farpour- Lambert N. Effects of Cast-Mediated Immobilization on Bone Mineral Mass at Various Sites in Adolescents with Lower-Extremity Fracture. J Bone Joint Surg Am. 2012; 94(3): 208-16.
Looker AC, Orwoll ES, Johnston CC Jr, Lindsay RL, Wahner HW, Dunn WL, et al. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res. 1997; 12(11): 1769-71.
Lee J, Vasikaran S. Current recommendations for laboratory testing and use of bone turnover markers in management of osteoporosis. Ann Lab Med. 2012; 32(2): 105-12.
Thomas T, Burguera B, Melton III LJ, Atkinson EJ, O’Fallon WM, Riggs BL, Khosla S. Role of serum leptin, insulin, and estrogen levels as potential mediators of the relationship between fat mass and bone mineral density in men versus women. Bone. 2001; 29(2): 114-20.
Hadidy EH, Ghonaim M, Gawad SS, Atta MA. Impact of severity, duration, and etiology of hyperthyroidism on bone turnover markers and bone mineral density in men. BMC Endocrine Disorders. 2011; 11: 15.
Roodman GD. Review Article: Mechanisms of Bone Metastasis. N Engl J Med. 2004; 350: 1655-64.
Meydan N, Barutca S, Guney E, Boylu S, Savk O, Culhaci N, Ayhan M. Brown tumors mimicking bone metastases. J Natl Med Assoc. 2006; 98(6): 950-3.
Pathological fractures due to bone metastases. Br Med J. 1981; 283(6294): 748.
Bringhurst FR, Demay MB, Kronenberg HM, Wysolmerski JJ. Insogna KL. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, (Eds.). Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008: chap. 27, 266.
Chandrasekar CR, Grimer RJ, Carter SR, Tillman RM, Abudu AT, Jeys LM. Outcome of pathologic fractures of proximal femur in nonosteogenic primary bone sarcoma. Eur J Surg Oncol. 2011; 37(6): 532-6.
Chapter 4: Endocrine, nutritional, and metabolic diseases. World Health Organization. WHO. 2006 Dec. icd10/browse/2010/en. Accessed Feb 3, 2012.
Chavassieux P, Seeman E, Delmas PD. Insights into Material and Structural Basis of Bone Fragility from Diseases Associated with. Fractures: How Determinants of the Biomechanical Properties of Bone Are Compromised by Disease. Endo Reviews. 2007; 28(2): 151-64.
Rubin MR, LiVolsi VA, Bandeira F, Caldas G, Bilezikian JP. Tc99m- Sestamibi Uptake in osteitis fibrosa cystica Simulating Metastatic Bone Disease. J Clin Endocrinol Metab. 2001; 86(11): 5138-41.
Arabi A, Khoury N, Zahed L, Birbari A, Fuleihan GE. Regression of Skeletal manifestations of hyperparathyroidism with oral vitamin D. J Clin Endocrinol Metab. 2006; 50(4): 657-63.
Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP. A 10-Year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999; 341: 1249-55.
Khan AA, Bilezikian JP, Kung AW, Ahmed M, Dubois SJ, Ho AY, et al. Alendronate in primary hyperparathyroidism: a double-blind, randomized, placebo-controlled trial. J Clin Endocrinol Metab. 2004; 89(7): 3319-25.
Selby PL, Peacock M. Ethinyl estradiol and norethindrone in the treatment of primary hyperparathyroidism in postmenopausal women. N Engl J Med. 1986; 314: 1481-5.
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