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Hyperparathyroidism

• Primary Hyperparathyroidism


 

• Due mostly to adenoma of one or more glands with increase in chief or oxyphil cells

• Rarely hyperplasia

• Even rarer with carcinoma

• Skeletal lesions have been called osteitis fibrosa cystica or Von Recklinghausen’s

• 15-20% who have hyperparathyroidism have x-ray findings

• Absence of subperiosteal resorption strongly mitigates against the diagnosis

• Brown tumors-benign, well-defined, radiolucent lesion

• Cystic lesion

• May be multiple and look like mets

• Pathologic fractures are common

• Soft tissue calcification is more common in secondary, except for knee medial meniscus calcification which is more common in primary

• Secondary hyperparathyroidism

• Hyperplasia

• Rarely adenoma

• Mostly chief or clear cell

• Brown tumors less common

• Soft tissue calcification more common

• Calcified deposits around joints may mimic tumoral calcinosis

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