Giant Parathyroid Adenoma-Associated Fracture, Not All Lytic Bone Lesions are Cancer: A Case-Based Review

Introduction. Due to the early diagnosis of primary hyperparathyroidism the musculoskeletal manifestations of this disease are becoming less frequent. When this disease manifests secondary to a giant adenoma, it presents with more aggressive symptoms and can have important repercussions such as the...

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Bibliographic Details
Published in:Case reports in medicine 2022-01, Vol.2022, p.3969542-10
Main Authors: Alvarez-Payares, Jose C., Ribero, Marcel E., Ramírez-Urrea, Sara, Fragozo-Ramos, María C., Agámez-Gómez, Jose E., Román-González, Alejandro, Arias, Luis F., Arenas, Roberto Benavides, López-Urbano, Fernando
Format: Article
Language:English
Subjects:
Adenoma
Arthritis
Biopsy
Bone cancer
Bone lesions
Bone tumors
Calcemia
Cancer
Cardiac arrhythmia
Case Report
Case reports
Complications
Dietary supplements
Dyspnea
Fractures
Hyperparathyroidism
Hypocalcemia
Intravenous administration
Laboratories
Literature reviews
Metastases
Metastasis
Orthopedics
Pain
Parathyroid
Parathyroid hormone
Parathyroidectomy
Patients
Phosphatase
Postoperative
Scintigraphy
Thyroid gland
Tumors
Zoledronic acid
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Summary:Introduction. Due to the early diagnosis of primary hyperparathyroidism the musculoskeletal manifestations of this disease are becoming less frequent. When this disease manifests secondary to a giant adenoma, it presents with more aggressive symptoms and can have important repercussions such as the hungry bone syndrome after parathyroidectomy. There are few reported cases of hyperparathyroidism secondary to a giant adenoma in the literature, as the presence of a brown tumor is often misinterpreted as a metastatic lesion from an unknown primary tumor. Methods. We describe a case and performed a literature review to identify all case reports. A literature search was carried out on PubMed/MEDLINE and EMBASE bibliographic databases. All available studies from May 2009 to May 2021 were included. Data were tabulated, and outcomes were cumulatively analyzed. Results. Twenty-four cases of primary hyperparathyroidism due to giant adenoma have been described; the majority were women, with a mean age of 52 years. They presented with heterogeneous symptoms such as palpable nodules (45%), bone pain (33%), brown tumor (12.5%), asymptomatic (12.5%), metabolic profile with a mean calcemia of 13.8 mg/dL, PTH 1109 ng/L, and mean tumor weight of 47.24 g. Conclusion. Primary hyperparathyroidism due to giant adenoma increases the risk of developing potentially serious postoperative complications such as hungry bone syndrome. This implies the need of implementing preventive measures comprising administration of intravenous zoledronic acid and early supplementation of oral calcium to prevent complications after resection.
ISSN:1687-9627
1687-9635
DOI:10.1155/2022/3969542