ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2017) 49 EP279 | DOI: 10.1530/endoabs.49.EP279

Medullary vertebral compression in primary hyperparathyroidism

Fedala Saida, Meskine Djamila, Kedad Lamia, Fafa Nadira & Toubal Zakia

Laboratory of Endocrinology and Metabolism (LEM 1), Algiers, Algeria.

We report the case of an ectopic parathyroid adenoma, revealed by a medullary vertebral compression by a brown spinal tumor in a 44-year-old women. Physical examination revealed a lower limb weakness, paresthesia and radicular lower extremity pain. Magnetic resonance imaging (MRI) showed osteolytic vertebral lesions suggesting metastatic localizations. A thoracic CT scan identified a mediastinal mass measuring 6.2 cm in the major axis. Biological evaluation revealed a hypercalcemia (135 mg/l) with very high PTH (1896 pg /ml), parathyroid scintigraphy confirmed the mediastinal ectopic parathyroid. The patient underwent surgical resection of the mediastinal mass that proved to be a parathyroid ectopic adenoma. She showed a remarkable improvement in her clinical condition observed 6 months after parathyroidectomy. Medullary vertebral compression by a brown spinal tumor in primary hyperparathyroidism is rare, surgery of parathyroid adenoma improved clinical condition without resection of the brown tumor, However surgical decompression may be necessary in some cases.

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