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- Title
A Complex Case of Renal Tertiary Hyperparathyroidism with a very Rare Brown Tumour of the Jaw Requiring Treatment with Initial Subtotal Parathyroidectomy followed by Maxillary Surgery and Haemodialysis.
- Authors
Talapatra, Indrajit; Pothula, Vijay
- Abstract
We describe here the case of a middle-aged woman who presented to the endocrine clinic in 2020 with chronic renal impairment and raised PTH (parathyroid hormone). The patient had seen an endocrinologist with anorexia nervosa and electrolyte abnormalities several years ago, a few times and was subsequently lost to follow-up. On this occasion her serum calcium was varying from normal to high, phosphate was normal, alkaline phosphatase high and PTH was high as well. Ultrasound of the neck suggested a radiologically U3 (indeterminate) nodule on the right lobe of thyroid and a possible parathyroid adenoma on the left which was not confirmed on sestamibi scan. The FNA (Fine needle Aspiration) of the right thyroid nodule suggested Papillary carcinoma. The patient also was found to have a Brown tumour of the maxilla, a very rare bone lesion secondary to renal hyper-parathyroidism. The patient initially underwent right haemithyroidectomy and subtotal parathyroidectomy with eventual completion left thyroidectomy. There was no improvement of this bone lesion despite lowering of PTH following subtotal parathyroidectomy and as such the patient required maxillary surgery one year later. The patiently remains currently on haemodialysis.
- Subjects
CHRONIC kidney failure; JAW tumors; ULTRASONIC imaging; THYROIDECTOMY; PAPILLARY carcinoma; HYPERPARATHYROIDISM; PARATHYROID hormone; HEALTH care teams; ANOREXIA nervosa; ELECTROLYTES; BLOOD testing; NEEDLE biopsy
- Publication
Journal of the Indian Academy of Clinical Medicine, 2023, Vol 24, Issue 2, p152
- ISSN
0972-3560
- Publication type
Article