Primary Hyperparathyroidism with Multiple Fractures and Brown Tumors in a 14-year-old Girl: Case Report & Review of Literature

Authors

  • Nasim Khan Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • Nazmun Nahar Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • Rawshan Ara Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • Fahima Akter Dowel Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • Shakila Zaman Rima Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • Ratan Kumar Chakraborty Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • - Nadiruzzaman Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • Saiyeeda Mahmood Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh
  • Gazi Abul Hossain Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh Medical College Hospital Campus, Mymensingh-2200, Bangladesh

DOI:

https://doi.org/10.3329/bjnm.v22i2.51765

Keywords:

Hyperparathyroidism, pathological fracture, brown tumor, parathyroid adenoma, bone scintigraphy

Abstract

Primary hyperparathyroidism (PHPT) presenting as pathological fractures with brown tumors is very rare in children. The rarity and variable presentation of PHPT can make its diagnosis a challenge – especially in the developing countries where malnutrition may mask hypercalcemia. We report a case of a 14–year-old girl who presented with muscle pain, multiple fractures and bone pain. Laboratory tests revealed normocalcemia with vitamin D insufficiency. Subsequent biochemical, radiographic and scintigraphic findings were consistent with primary hyperparathyroidism due to a parathyroid adenoma. Tumor resection was done in a local hospital and histopathology confirmed parathyroid adenoma. Following parathyroidectomy, fractures were treated conservatively with supplementation of calcium and vitamin D. We found her quite capable of self-care and walking in good health at 1 year follow up. Though rare, PHPT-causing brown tumors related skeletal fractures is an important differential diagnosis in the evaluation of patients presenting with multiple foci of radiotracer uptake in bone scintigraphy.

Bangladesh J. Nuclear Med. 22(2): 130-136, Jul 2019

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Published

2021-02-01

How to Cite

Khan, N., Nahar, N., Ara, R., Dowel, F. A., Rima, S. Z., Chakraborty, R. K., Nadiruzzaman, .-., Mahmood, S., & Hossain, G. A. (2021). Primary Hyperparathyroidism with Multiple Fractures and Brown Tumors in a 14-year-old Girl: Case Report & Review of Literature. Bangladesh Journal of Nuclear Medicine, 22(2), 130–136. https://doi.org/10.3329/bjnm.v22i2.51765

Issue

Section

Review Articles