Healing of osteitis fibrosa cystica after partial parathyroidectomy despite persistent parathyroid hyperfunction: a case report
Mautalen, C.A.; Gonzalez, D.; Casco, C.; Fromm, G.A.
Metabolic Bone Disease and Related Research 4(3): 187-191
1982
ISSN/ISBN: 0221-8747 PMID: 7154936 Document Number: 195947
The diagnosis of primary hyperparathyroidism was made in a 55-yr-old female with marked hyercalcemia (15 mg/100 ml) and hypercalciuria and skeletal X-rays showing typical lesions of subperiosteal resorption and numerous cystic areas. At surgery a left lower parathyroid adenoma presumably was totally excised. Serum Ca returned to normal levels immediately postoperatively, but 4 mo. after surgery hypercalcemia (11.5 mg/100 ml) was again found. During the following 18 mo. the patient was free of symptoms, and radiologic studies revealed complete healing of the subperiosteal resorption and repair of the bone cysts. Cortical bone mineral content also increased. Elevated levels of serum parathyroid hormone (PTH) and Ca clearly indicated the persistence of primary hyperparathyroidism. A decrease in the degree of PTH hypersecretion permitted the repair of the skeletal lesions caused by a more severe level of parathyroid hyperfunction.