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.
20 - 23 May 2017
European Society of Endocrinology