Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria;
Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria.
Anticancer Res. 2021 Jun;41(6):3083-3089. doi: 10.21873/anticanres.15092.
BACKGROUND/AIM: Pathological fractures are rare, suspicious and in some cases mentioned as the first sign of a malignant tumor. We present an uncommon case with a pathological fracture of the tibia diaphysis as the first sign of severe hyperparathyroidism.
We report the case of a female patient who was referred to the emergency department with a history of progressively worsening pain in the lower left leg and an inability to fully bear weight. No history of trauma or any other injury was reported. An x-ray revealed an extensive osteolytic lesion in the tibial shaft with cortical bone destruction.
Our case, together with very few cases described in the current literature, emphasizes that in the presence of hypercalcemia and lytic lesions primary hyperparathyroidism should always be considered as a differential diagnosis. Lytic bone lesions can lead to pathological fractures and severe impairment of quality of life.
背景/目的：病理性骨折较为罕见且易被怀疑，在某些情况下，其可作为恶性肿瘤的首发症状。我们报告了一例不常见的病例，其胫骨骨干的病理性骨折是重度甲状旁腺功能亢进的首发表现。
我们报告了一例女性患者的病例，其因左小腿进行性加重的疼痛和无法完全负重而被送至急诊。未报告有创伤或任何其他损伤的病史。X 射线显示胫骨干广泛的溶骨性病变伴皮质骨破坏。
我们的病例以及目前文献中描述的极少数病例强调，在存在高钙血症和溶骨性病变的情况下，原发性甲状旁腺功能亢进症应始终作为鉴别诊断的一种考虑。溶骨性骨病变可导致病理性骨折和严重的生活质量受损。
