Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4681-4687
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4681
Parathyroid adenoma combined with a rib tumor as the primary disease: A case report
Lu Han, Xiao-Feng Zhu
Lu Han, College of Medicine, Jiamusi University, Jiamusi 154000, Heilongjiang Province, China
Xiao-Feng Zhu, Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi 154000, Heilongjiang Province, China
Author contributions: Zhu XF performed the operation; Han L collected the case data and drafted the article; Zhu XF made critical revisions to the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Feng Zhu, MD, Chief Doctor, Professor, Surgeon, Surgical Oncologist, Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, No. 348 Dexiang Street, Xiangyang District, Jiamusi 154000, Heilongjiang Province, China. jiamusizxf@163.com
Received: April 27, 2020
Peer-review started: April 27, 2020
First decision: May 1, 2020
Revised: May 11, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 6, 2020
Processing time: 153 Days and 20.4 Hours
Abstract
BACKGROUND

Parathyroid adenoma is a benign parathyroid tumor, with serum parathyroid hormone and calcium ion concentrations as the typical basis for diagnosis. Its clinical manifestations are complex and changeable; thus it is easily missed or misdiagnosed. Approximately 85% of patients with parathyroid adenoma develop primary hyperparathyroidism, and abnormalities in bones, kidneys and other organs can occur. Brown tumors are rare.

CASE SUMMARY

We report a rare case of fibrocystic osteitis associated with a parathyroid adenoma, which was discovered by chance due to a rib tumor. Abnormally elevated serum parathyroid hormone and calcium ion were found before surgery. We suspected primary hyperparathyroidism, and color Doppler ultrasound suggested the presence of a thyroid mass. With informed consent by the patient and her family, we first removed the rib tumor, and one week later, resection of the parathyroid adenoma and thyroid mass was performed on both sides, and the patient recovered well after surgery.

CONCLUSION

In the case of parathyroid adenoma combined with brown tumor, the bone cyst will gradually decrease in size with time without treatment. If not, surgery should be performed as soon as possible.

Keywords: Parathyroid adenoma; Rib; Brown tumor; Primary hyperparathyroidism; Treatment; Operation; Case report

Core Tip: We report a rare and interesting case of fibrocystic osteitis associated with a parathyroid adenoma, which was discovered by chance due to a rib tumor. The patient only had respiratory symptoms. Computed tomography examination revealed a huge mass on the right rib and a suspected giant cell tumor of the bone. Interestingly, abnormal serum parathyroid hormone and calcium ion were found preoperatively and further examination revealed primary hyperparathyroidism. The pathology of the rib tumor showed a bone cyst, suggesting that this rib tumor was likely related to parathyroid adenoma.