Yilmaz T.S., Valeeva F.V., Nuraeva A.A. Ectopic parathyroid adenoma as a cause of developmentof osteitis fibrosa cystica (clinical case). Head and neck. Russian Journal. 2025;13(1):94–98
DOI: https://doi.org/10.25792/HN.2025.13.1.94-98
Introduction. Primary hyperparathyroidism occupies the third place among all endocrinopathies and is the maincause of hypercalcemia in outpatients. The prevalence of the disease is 1–2 cases per 1000 population. Womenget the disease 2 times more often than men. The peak incidence is at the age of 40-60 years. Availability ofdetermination of calcium and parathyroid hormone levels in blood serum allows to detect asymptomatic forms ofthe disease at the earliest stages of development. At the same time, we meet patients with severe complicationsduring outpatient appointments. Osteitis fibrosa cystica is the final stage of primary hyperparathyroidism, whichdevelops due to long-term hyperproduction of parathyroid hormone. This complication is associated with severepain, skeletal deformities, gait disturbance, which certainly reduces the quality of life of the patient. In addition, thereare several diagnostic difficulties, as the radiological pattern is often interpreted as giant cell tumor of the bone. Theonly way to prevent this condition is timely diagnosis of primary hyperparathyroidism, topical diagnosis of parathyroidadenoma/hyperplasia and subsequent surgical treatment.
Case report. In this article we would like to present a clinical case of a 72-year-old patient who developed osteitisfibrosa cystica within 6–7 years after the diagnosis of postmenopausal osteoporosis treated with ibandronic acid. Atthe same time, increased levels of both calcium and parathyroid hormone were registered at the time of diagnosis,but the required additional investigations were not performed.
Conclusion. Osteoporosis should be a diagnosis of exclusion, made in cases where no other causes for decreasedbone mineral density have been identified. When hypercalcemia and elevated PTH levels are detected, topicalassessment of the parathyroid glands should be performed, as parathyroidectomy is the only treatment for PHPTthat effectively prevents complications.
Keywords: primary hyperparathyroidism, osteoporosis, osteitis fibrosa cystica, hypercalcemia, parathyroid hormone,parathyroidectomy, giant cell tumor of the bone, ectopic parathyroid
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study