Campo Francesco Rosario, Di Sacco Federico, D'Arienzo Antonio, Ipponi Edoardo, Cosseddu Fabio, Bottai Vanna, Barreca Sebastiano, Andreani Lorenzo, Parchi Paolo Domenico
Department of Orthopedics and Trauma Surgery, University of Pisa, Pisa, Italy.
Department of Orthopedics and Trauma Surgery, Grande Ospedale Metropolitano, Reggio Calabria, Italy.
J Med Case Rep. 2025 May 28;19(1):256. doi: 10.1186/s13256-025-05295-y.
Aneurysmal bone cysts are benign, locally aggressive bone lesions that commonly affect young adults and adolescents. These cysts, which may cause pain, fractures, or deformities, are often associated with vascular or abnormal bone resorption processes. Though their etiology is not fully understood, an intriguing and rarely discussed correlation between aneurysmal bone cysts and endocrine disorders, particularly primary hyperparathyroidism, has been reported. Hyperparathyroidism, usually resulting from a parathyroid adenoma, promotes osteoclastic activity, which can lead to bone resorption and potentially the formation of aneurysmal cysts. The diagnosis of hyperparathyroidism can be challenging, especially in the absence of characteristic clinical signs.
A 47-year-old Albanian Caucasian female individual, with a body mass index of 40, presented with coxalgia and an incidental finding of an osteolytic lesion in the right sacral wing on pelvic X-ray. Subsequent imaging, including magnetic resonance imaging and computed tomography, confirmed the presence of a large aneurysmal bone cyst. Despite its size, traditional surgical interventions were not pursued owing to the discovery of primary hyperparathyroidism, as indicated by elevated serum calcium and parathyroid hormone levels. A parathyroid ultrasound revealed an atypical adenoma in the left lower parathyroid, confirming the diagnosis of hyperparathyroidism. The patient underwent successful parathyroidectomy and left thyroid loboistectomy with a favorable outcome. Postsurgical follow-up revealed normalization of metabolic parameters and clinical resolution of symptoms, with stable dimensions of the sacral cyst.
This case emphasizes the importance of thorough diagnostic evaluation in patients with bone lesions, particularly in those with risk factors for metabolic bone disorders. Primary hyperparathyroidism, although rare, can manifest with bone abnormalities such as aneurysmal cysts. A multidisciplinary approach, including timely diagnosis and surgical intervention, is crucial for optimal management and preventing long-term complications. Regular follow-up and monitoring of metabolic parameters are key to ensuring successful outcomes.
骨动脉瘤性囊肿是一种良性、具有局部侵袭性的骨病变，常见于年轻成年人和青少年。这些囊肿可能会引起疼痛、骨折或畸形，通常与血管或异常的骨吸收过程有关。尽管其病因尚未完全明确，但已有报道称骨动脉瘤性囊肿与内分泌紊乱，尤其是原发性甲状旁腺功能亢进之间存在一种有趣且鲜少被讨论的关联。甲状旁腺功能亢进通常由甲状旁腺腺瘤引起，它会促进破骨细胞活性，进而导致骨吸收，并可能引发动脉瘤性囊肿的形成。甲状旁腺功能亢进的诊断可能具有挑战性，尤其是在缺乏典型临床症状的情况下。
一名47岁的阿尔巴尼亚裔白种女性，体重指数为40，因髋部疼痛就诊，骨盆X线检查偶然发现右骶骨翼有一个溶骨性病变。随后的影像学检查，包括磁共振成像和计算机断层扫描，证实存在一个大型骨动脉瘤性囊肿。尽管囊肿较大，但由于血清钙和甲状旁腺激素水平升高提示原发性甲状旁腺功能亢进，因此未采取传统手术干预措施。甲状旁腺超声检查发现左下甲状旁腺有一个非典型腺瘤，确诊为甲状旁腺功能亢进。该患者接受了成功的甲状旁腺切除术和左侧甲状腺叶切除术，预后良好。术后随访显示代谢参数恢复正常，症状临床缓解，骶骨囊肿大小稳定。
本病例强调了对骨病变患者进行全面诊断评估的重要性，尤其是那些有代谢性骨病危险因素的患者。原发性甲状旁腺功能亢进虽然罕见，但可表现为骨异常，如动脉瘤性囊肿。多学科方法，包括及时诊断和手术干预，对于优化管理和预防长期并发症至关重要。定期随访和监测代谢参数是确保成功治疗结果的关键。
