Endocrine Abstracts

A 55-year-old Saudi woman with a complaint of anterior maxilla mass of 1 month duration. Initial examination revealed a painful mass in the anterior maxilla. Surgery was not undertaken because routine laboratory investigations revealed hypercalcemia.

Initial laboratory tests performed on admission showed the following: alkaline phosphates 143 IU/l, corrected serum calcium 3.2 mmol/l, PTH 120 pmol/l A provisional diagnosis was made for hypercalcemia due to hyperparathyroidism. Technetium thallium (99mTc-201Th) subtraction scintigraphy (Sestamibi scanning), which demonstrated a single, ectopic anterior mediastinal parathyroid adenoma. Treatment was initiated by hydration and intravenous bisphosphonate. Initially the patient underwent extirpation of the mass and curettage of the bone. Histological sections showed multiple giant cells consistent with Brown tumour of primary hyperparathyroidism. She underwent mediastinal parathyroidectomy by median sternotomy. The post-operative course was uneventful and the patient was discharged on the 6th post-operative day without complications. postoperative laboratory tests were normal.

Conclusions: Due to recent improvements in analytical techniques, the diagnosis of hyperparathyroidism usually occurs when the disease is in an asymptomatic phase, and the incidence of patients with advanced bone lesions is rare. The treatment of choice for bone lesions is parathyroidectomy.

A 55-year-old Saudi woman with a complaint of anterior maxilla mass of 1 month duration. Initial examination revealed a painful mass in the anterior maxilla. Surgery was not undertaken because routine laboratory investigations revealed hypercalcemia.

Initial laboratory tests performed on admission showed the following: alkaline phosphates 143 IU/l, corrected serum calcium 3.2 mmol/l, PTH 120 pmol/l A provisional diagnosis was made for hypercalcemia due to hyperparathyroidism. Technetium thallium (99mTc-201Th) subtraction scintigraphy (Sestamibi scanning), which demonstrated a single, ectopic anterior mediastinal parathyroid adenoma. Treatment was initiated by hydration and intravenous bisphosphonate. Initially the patient underwent extirpation of the mass and curettage of the bone. Histological sections showed multiple giant cells consistent with Brown tumour of primary hyperparathyroidism. She underwent mediastinal parathyroidectomy by median sternotomy. The post-operative course was uneventful and the patient was discharged on the 6th post-operative day without complications. postoperative laboratory tests were normal.