Advanced, lately diagnosed primary hyperparathyroidism in a patient mistakenly treated for multiple bone metastasis. A case report and review of the literature

Abstract

We report a case of 66-years-old woman mistakenly diagnosed as a metasases’ dissemination on a basis of mulitifocal skeleton lesion showed by 99mTc-MDP scanning, high serum calcium level and a vague breast tumour history. Additionally she suffered had humer and femur fractures. Immobilised and diagnosed as a cancer patient, she he was referred to palliative care. In hospice for the first time the suspicion of hyperparathyroidism was raised. When 99mTc-MIBI SPECT/CT scan revealed a parathyroid adenoma, also considering her biochemical parameters, she underwent the surgery. Following this her biochemical parameters normalised. This case illustrates a pitfall, which sometimes happens in this rare disease. A review of literature is provided.We report a case of 66-years-old woman mistakenly diagnosed as a metasases’ dissemination on a basis of mulitifocal skeleton lesion showed by 99mTc-MDP scanning, high serum calcium level and a vague breast tumour history. Additionally she suffered had humer and femur fractures. Immobilised and diagnosed as a cancer patient, she he was referred to palliative care. In hospice for the first time the suspicion of hyperparathyroidism was raised. When 99mTc-MIBI SPECT/CT scan revealed a parathyroid adenoma, also considering her biochemical parameters, she underwent the surgery. Following this her biochemical parameters normalised. This case illustrates a pitfall, which sometimes happens in this rare disease. A review of literature is provided