Jervis Lee, James Matthew, Howe Warwick, Richards Stephen
Intensive Care, Joondalup Health Campus, Perth, Western Australia, Australia.
General Medicine, Joondalup Health Campus, Joondalup, Western Australia, Australia.
BMJ Case Rep. 2017 May 28;2017:bcr-2017-220603. doi: 10.1136/bcr-2017-220603.
A 58-year-old female patient presented with several weeks history of significant bilateral knee pain. Initial knee radiographs demonstrated lucencies of the bony cortex while extensive osteolytic lesions on a routine chest radiograph were suggestive of multiple myeloma or bony metastases. Biochemical investigation revealed primary hyperparathyroidism with renal insufficiency. A parathyroid adenoma was demonstrated on a neck ultrasound and sestamibi scan and subsequently confirmed by histology. We illustrate a case of primary hyperparathyroidism with osteitis fibrosa cystica and brown tumours which were initially mistaken for malignant disease.
一名58岁女性患者出现双侧膝关节剧痛数周。最初的膝关节X线片显示骨皮质透亮区，而常规胸部X线片上广泛的溶骨性病变提示多发性骨髓瘤或骨转移。生化检查显示原发性甲状旁腺功能亢进伴肾功能不全。颈部超声和锝[99mTc]甲氧基异丁基异腈扫描显示甲状旁腺腺瘤，随后经组织学证实。我们展示了一例原发性甲状旁腺功能亢进伴纤维囊性骨炎和棕色瘤的病例，这些病变最初被误诊为恶性疾病。
