Parathyroid Adenoma Presenting with Multiple Long Bone Lytic Lesions in An Adult Female: A Diagnostic Dilemma

Lytic bone lesion is one of the manifestations of Parathyroid adenoma due to osteoclastic bone resorption. It is also referred to as Brown's tumor and it is characterized by elevated serum calcium and serum parathyroid hormone. Primary hyperparathyroidism is due to parathyroid adenoma in 80-85% of cases, hyperplasia in 10-15% of cases and carcinoma in 1-5% of cases. Our case is a 38year old female with multiple long bone lytic lesions resembling malignancies for which the primary source could not be identified from the clinical examination. A possible diagnosis of primary and secondary bone malignancies was made. Postoperative histological diagnosis gave a conflicting finding of fibrous dysplasia and non-ossifying fibroma. She was eventually found to have parathyroid adenoma for which she had partial parathyroidectomy with subsequent healing of the bone lesions.