Parathyroid Adenoma Presenting with Severe Skeletal Deformities

Muhammad Khawar Saeed; Faryal Siddique; Mishaal Mishaal

doi:10.70302/jpsim.v6i1.2517

Case Report

Parathyroid Adenoma Presenting with Severe Skeletal Deformities

Muhammad Khawar Saeed

Fatima Memorial Hospital, Lahore

Faryal Siddique

Fatima Memorial Hospital, Lahore

Mishaal Mishaal

Fatima Memorial Hospital, Lahore

✉ Correspondence: Muhammad Khawar Saeed Email: khawarcapri@gmail.com

DOI https://doi.org/10.70302/jpsim.v6i1.2517

Volume: 6, Issue 1 Pages: 82–85 Published: 10 Mar 2025

Received: 26 Jul 2024 Revised: 18 Feb 2025 Accepted: 23 Feb 2025 Published Online: 10 Mar 2025

Abstract

Parathyroid adenoma (PA) is the most common cause of primary hyperparathyroidism. Parathyroid hyperplasia and cancer are rare, accounting for less than 1% of cases1. PA is typically identified via ultrasonography. We present a case of a 17-year-old female with severe skeletal deformities and extensive osteolytic lesions. She underwent parathyroid adenoma excision and subsequently developed hungry bone syndrome, requiring calcium and vitamin D supplementation. Isolated skeletal abnormalities as the primary manifestation of parathyroid adenoma are rare.

Keywords

Hyperparathyroidism Hungry bone syndrome Parathyroid adenoma

How to Cite This Article

Saeed MK, Siddique F, Mishaal M. Parathyroid Adenoma Presenting with Severe Skeletal Deformities. J Pak Soc Intern Med. 2025;6(1):82–85. doi:10.70302/jpsim.v6i1.2517

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

Fang SH, Lal G. Parathyroid cancer. Endocr Pract. 2011;17(Suppl 1):36-43.
Fraker DL, Harsono H, Lewis R. Minimally invasive parathyroidectomy: benefits and requirements of localization, diagnosis, and intraoperative PTH monitoring. Long-term results. World J Surg. 2009; 33(11):2256-65.
Bilezikian JP, Silverberg SJ. Clinical practice. Asymptomatic primary hyperparathyroidism. N Engl J Med. 2004;350(17):1746-51.
Silaghi H, Valea A, Ghervan C, Silaghi AC. Ectopic intrathyroid parathyroid adenoma: diagnostic and therapeutic challenges due to multiple osteolytic lesions. Med Ultrason. 2011;13(3):241-4.
Soundarya N, Sharada P, Prakash N, Pradeep G. Bilateral maxillary brown tumors in a patient with primary hyperparathyroidism: report of a rare entity and review of literature. J Oral Maxillofac Pathol. 2011;15(1):56-9.
Karvounaris DC, Symeonidis N, Triantafyllou A, Flaris N, Sakadamis A. Ectopic parathyroid adenoma located inside the hypoglossal nerve. Head Neck. 2010;32(9):1273-6.
Arnault V, Beaulieu A, Lifante JC, Sitges Serra A, Sebag F, Mathonnet M, et al. Multicenter study of 19 aortopulmonary window parathyroid tumors: the challenge of embryologic origin. World J Surg. 2010;34(6):2211-6.
Yadav R, Mohammed TL, Neumann DR, Mihaljevic T, Hoschar A. Case of the season: ectopic parathyroid adenoma in the pericardium: a report of robotically assisted minimally invasive parathyroidectomy. Semin Roentgenol. 2010;45(1):53-6.
Saliba W, Barnett O, Rennert HS, Lavi I, Rennert G. The relationship between serum 25(OH)D and parathyroid hormone levels. Am J Med. 2011;124(12):1165-70.
Abboud B, Sleilaty G, Ayoub S, et al. Intrathyroid parathyroid adenoma in primary hyperparathyroidism: can it be predicted preoperatively? World J Surg. 2007;31(6):817-23.
Akram K, Parker JA, Donohoe K, Kolodny G. Role of single photon emission computed tomography/computed tomography in localization of ectopic parathyroid adenoma: a pictorial case series and review of the current literature. Clin Nucl Med. 2009;34(3)500-2.
Seethala RR, Virji MA, Ogilvie JB. Pathology of the parathyroid glands. In: Barnes L, ed. Surgical Pathology of the Head and Neck. Vol III. New York, NY: Informa Health Care; 2009:pp. 1429-72.
The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons. Position statement on the diagnosis and management of primary hyperparathyroidism. Endocr Pract. 2005;11(1):49-54.
Parker CR, Blackwell PJ, Fairbairn KJ, Hosking DJ. Alendronate in the treatment of primary hyperparathyroid-related osteoporosis: a 2-year study. J Clin Endocrinol Metab. 2002;87(10):4482.
Greene AB, Butler RS, McIntyre S, et al. National trends in parathyroid surgery from 1998 to 2008: a decade of change. J Am Coll Surg. 2009;209(3):332-43.
Lew JI, Irvin GL 3rd. Focused parathyroidectomy guided by intraoperative parathormone monitoring does not miss multiglandular disease in patients with sporadic primary hyperparathyroidism: a 10-year outcome. Surgery. 2009;146(6):1021-7.

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CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.

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[1] Fang SH, Lal G. Parathyroid cancer. Endocr Pract. 2011;17(Suppl 1):36-43.

[2] Fraker DL, Harsono H, Lewis R. Minimally invasive parathyroidectomy: benefits and requirements of localization, diagnosis, and intraoperative PTH monitoring. Long-term results. World J Surg. 2009; 33(11):2256-65.

[3] Bilezikian JP, Silverberg SJ. Clinical practice. Asymptomatic primary hyperparathyroidism. N Engl J Med. 2004;350(17):1746-51.

[4] Silaghi H, Valea A, Ghervan C, Silaghi AC. Ectopic intrathyroid parathyroid adenoma: diagnostic and therapeutic challenges due to multiple osteolytic lesions. Med Ultrason. 2011;13(3):241-4.

[5] Soundarya N, Sharada P, Prakash N, Pradeep G. Bilateral maxillary brown tumors in a patient with primary hyperparathyroidism: report of a rare entity and review of literature. J Oral Maxillofac Pathol. 2011;15(1):56-9.

[6] Karvounaris DC, Symeonidis N, Triantafyllou A, Flaris N, Sakadamis A. Ectopic parathyroid adenoma located inside the hypoglossal nerve. Head Neck. 2010;32(9):1273-6.

[7] Arnault V, Beaulieu A, Lifante JC, Sitges Serra A, Sebag F, Mathonnet M, et al. Multicenter study of 19 aortopulmonary window parathyroid tumors: the challenge of embryologic origin. World J Surg. 2010;34(6):2211-6.

[8] Yadav R, Mohammed TL, Neumann DR, Mihaljevic T, Hoschar A. Case of the season: ectopic parathyroid adenoma in the pericardium: a report of robotically assisted minimally invasive parathyroidectomy. Semin Roentgenol. 2010;45(1):53-6.

[9] Saliba W, Barnett O, Rennert HS, Lavi I, Rennert G. The relationship between serum 25(OH)D and parathyroid hormone levels. Am J Med. 2011;124(12):1165-70.

[10] Abboud B, Sleilaty G, Ayoub S, et al. Intrathyroid parathyroid adenoma in primary hyperparathyroidism: can it be predicted preoperatively? World J Surg. 2007;31(6):817-23.

[11] Akram K, Parker JA, Donohoe K, Kolodny G. Role of single photon emission computed tomography/computed tomography in localization of ectopic parathyroid adenoma: a pictorial case series and review of the current literature. Clin Nucl Med. 2009;34(3)500-2.

[12] Seethala RR, Virji MA, Ogilvie JB. Pathology of the parathyroid glands. In: Barnes L, ed. Surgical Pathology of the Head and Neck. Vol III. New York, NY: Informa Health Care; 2009:pp. 1429-72.

[13] The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons. Position statement on the diagnosis and management of primary hyperparathyroidism. Endocr Pract. 2005;11(1):49-54.

[14] Parker CR, Blackwell PJ, Fairbairn KJ, Hosking DJ. Alendronate in the treatment of primary hyperparathyroid-related osteoporosis: a 2-year study. J Clin Endocrinol Metab. 2002;87(10):4482.

[15] Greene AB, Butler RS, McIntyre S, et al. National trends in parathyroid surgery from 1998 to 2008: a decade of change. J Am Coll Surg. 2009;209(3):332-43.

[16] Lew JI, Irvin GL 3rd. Focused parathyroidectomy guided by intraoperative parathormone monitoring does not miss multiglandular disease in patients with sporadic primary hyperparathyroidism: a 10-year outcome. Surgery. 2009;146(6):1021-7.