A case of Parathyroid adenoma presenting with severe Von Recklinghausens disease of bone.

Abstract

Abstract :
A 41 year old male presented with one
year history of progressively increasing
pain and swelling over the left leg. Physical
examination revealed bony swellings
over the left tibia and phalanges. Blood
investigations revealed features of hyper
parathyroidism and on nuclear imaging
superior parathyroid adenoma was imaged.
Bony lesions were found to be severe
presentation of hyper parathyroidism,
Von Recklinghausens disease of
bone also known as osteitis fibrosa cystica.
Left superior parathyroidectomy was
performed after evaluation. Osteitis Fibrosa
Cystica is a severe complication of
hyperparathyroidism in which osteolysis
and bone resorption occurs and it becomes
deformed caused by surplus PTH
from overactive parathyroid glands.
Keyword :Parathyroid adenoma, Von
Recklinghausens disease, osteitis fibrosa
cystica
A 41 year old male presented with complaints
of progressively increasing pain
over the left leg for duration of one year
and progressive swelling over the left leg
for nine months. Patient gave history of
polyuria, vomiting, polydipsia, lethargy and
fatigue for a period of 6 months on eliciting
further history. Patient had a pathological
fracture of right humerus two years back
and left hydronephrosis two years
back ,diagnosed as left pelviureteric stone,
treated with ESWL. Patient was not a
smoker,not alcoholic and vegetarian. There
was no other significant history. Physical
examination revealed two hard non mobile
masses of size 6x6 cm and 2x2 cm over
the left tibia(Fig-1) and 2x2 cm hard swelling
over the first interphalengeal joint of left
fourth finger(Fig-2). Neck examination didn’t
reveal any palpable mass(Fig-3).