Pathological subtrochanteric fracture revealing a primary hyperparathyroidism: A case report

Area of Science:

• Endocrinology
• Orthopedic Surgery
• Oncology

Background:

• Primary hyperparathyroidism is a common endocrine disorder, but pathological fractures are rare presentations.
• It is the most frequent cause of hypercalcemia, often due to parathyroid adenomas.

Observation:

• A 30-year-old male presented with a subtrochanteric femur fracture after a minor fall.
• Imaging revealed multifocal lytic bone lesions, renal lithiasis, and a thyroid nodule.
• Histopathology confirmed primary hyperparathyroidism with a brown tumor.

Findings:

• Elevated serum calcium and parathyroid hormone (PTH) levels confirmed the diagnosis.
• The patient underwent surgical fixation of the femur fracture followed by parathyroidectomy.
• Six-month follow-up showed satisfactory functional recovery.

Implications:

• Brown tumors should be considered in the differential diagnosis of multifocal osteolytic bone lesions.
• Prompt diagnosis and surgical intervention are vital for managing primary hyperparathyroidism presenting with pathological fractures.