Primary hyperparathyroidism causing putty kidney with brown tumor located in the pubic ramus

Area of Science:

• Endocrinology
• Nephrology
• Oncology

Background:

• Primary hyperparathyroidism (pHPT) involves excessive parathyroid hormone secretion.
• Classical symptoms include renal stones, hypercalcemia, soft tissue calcifications, and bone disease.
• Most pHPT cases are diagnosed early, but late presentations occur.

Observation:

• A patient presented with advanced pHPT.
• Observed were extensive parenchymal calcifications forming a "putty kidney."
• A Brown tumor was noted in the pubic ramus.

Findings:

• The case illustrates a rare, late-stage presentation of primary hyperparathyroidism.
• Demonstrates significant renal involvement with a "putty kidney" formation.
• Highlights the occurrence of Brown tumors in advanced hyperparathyroidism.

Implications:

• Emphasizes the need for vigilance in diagnosing pHPT, even with atypical or severe symptoms.
• Underscores the potential for severe renal and bone complications in untreated or late-diagnosed pHPT.
• Informs clinical practice regarding the spectrum of pHPT manifestations.