HYPERPARATHYROIDISM—SIMULATING PAGET'S DISEASE

Abstract

A case report of a 39-yr.-old woman who presented coexistent features of hyperparathyroidism and Paget''s disease. The patient was admitted primarily for hypertensive disease, and bony lesions were discovered on a routine chest roentgenogram. Clinically, chemically, and roentgeno-graphically the patient presented a classical case of hyperparathyroidism except for the X-ray appearance of the skull which was compatible with that of Paget''s disease. An adenoma of the parathyroid gland was extirpated surgically. Five yrs. after parathyroidectomy, the patient presented roentgenologic evidence of Pagetic changes in the skull, pelvis, femora, ribs, and fingers. The blood chemistries were also all normal. The case is presented as one of Recklinghausen''s disease which on healing acquired the bone picture of Paget''s disease. Because of the young age of the patient, the reversion to normal of the serum alkaline phosphatase, the unusual distribution of the lesions, especially in the ribs and fingers, and the surgically proven diagnosis of hyperparathyroidism, this is felt to be so.