Primary hyperparathyroidism-Jaw tumor syndrome: a confusing and forgotten diagnosis
DOI:
https://doi.org/10.15386/cjmed-638Keywords:
primary hyperparathyroidism, jaw tumor, bone scan, 99m Tc-MIBIAbstract
Background. Primary hyperparathyroidism is caused by the excessive growth of parathormone secretion, its consequence being hypercalcemia. The parathyroid adenoma is responsible for over half of primary hyperparathyroidism cases. The mandibular tumor can be the initial sign in the case of primary hyperparathyroidism.
Case presentation. We present the case of a 33 year old patient with history of a mandibular operated tumor, repetitive pathological fractures and hypercalcemia manifestations. The level of the parathormone at the first measurement indicated a very high value. The parathyroid scintigraphy with 99mTc-MIBI (methoxy-isobutyl-isonitrile) evidenced a high uptake of the tracerin the superior mediastinum, suggestive for an ectopic parathyroid adenoma. The histopathological examination after surgery leads to the diagnosis of parathyroid adenoma. The association between the primary hyperparathyroidism, the mandibular tumour, the clinical history and the nuclear imaging lead to the diagnosis of primary hyperparathyroidism – Jaw tumor syndrome.
Conclusion. The hyperparathyroidism-Jaw tumor syndrome has a special clinical importance because of the severe and progressive symptomatology, and because of the risk of developing neoplasia of parathyroid glands, which have a reserved prognosis.
Downloads
Additional Files
- Figure 3. Hematoxilin-eosin staining 25x of the ectopic adenoma
- Figure 1. Parathyroid scintigraphy with 99mTc-MIBI. Ectopic parathyroid macroadenoma in the superior mediastinum
- Figure 4.Proliferation index ki-67 in the atypical parathyroid adenoma. HE-
- Figure 2. Bone scan 99mTc-MDP; multiple bone lesions
- 638 Conflict of interests
- 638 Copyright
Published
How to Cite
Issue
Section
License
The authors are required to transfer the copyright of the published paper to the journal. This is done by agreeing to sign the Copyright Assignment Form. Whenever the case, authors are also required to send permissions to reproduce material (such as illustrations) from the copyright holder.
The papers published in the journal are licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.