Severe bone deformities in primary hyperparathyroidism

The classic description of primary hyperparathyroidism (PHPT) is as a disease of kidneystones and bones. However, the clinical manifestation of osteitis fibrosa cystica with severe bonechanges is rare in modern medicine. We present a clinical case of a 30-year-old man with severebone deformities of the long bones, scoliosis, brown tumors and severe osteoporosis. At the timeof the diagnosis, he has the classic biochemical and hormonal picture of primaryhyperparathyroidism: severe hypercalcemia, hypophosphatemia, and significantly elevatedparathyroid hormone values. The changes are temporarily affected after surgical treatment of theparathyroid adenoma. After a four-year loss to follow-up, the patient presented with worseningsymptoms and hypercalcemia, possibly due to incomplete tumor removal. The bone changes aredebilitating and imply incomplete reverse development, considering their severity and duration.Comparison is made with other similar cases in the literature.