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Unusual pathological fracture of the clavicle revealing primary hyperparathyroidism: a case report.

Unusual pathological fracture of the clavicle revealing primary hyperparathyroidism: a case report.
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Benameur Y, Guerrouj H, Ghfir I, Ben Rais Aouad N,


Benameur Y, Guerrouj H, Ghfir I, Ben Rais Aouad N, (click to view)

Benameur Y, Guerrouj H, Ghfir I, Ben Rais Aouad N,

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Journal of medical case reports 2017 12 0911(1) 342 doi 10.1186/s13256-017-1509-7
Abstract
BACKGROUND
Primary hyperparathyroidism revealed by a pathological fracture is very uncommon; in the majority of cases the discovery of lytic bone lesions on imaging examinations evokes in the clinician first a neoplastic etiology and a metabolic origin is often omitted. This case report adds to the existing literature as it describes an unusual presentation of primary hyperparathyroidism.

CASE PRESENTATION
We report a case of a 50-year-old Moroccan man, without any known tumor, who presented a fracture of his left clavicle with multiple osteolytic lesions on computed tomography suggesting bone metastases. However, bone scintigraphy oriented the diagnosis to a metabolic pathology by showing a metabolic bone "super scan" with increased tracer uptake in the left clavicle; parathyroid scintigraphy was able to localize pathological right parathyroid tissue.

CONCLUSIONS
Whenever multiple osteolytic lesions are found in a patient without any known tumor, metabolic bone diseases including hyperparathyroidism should be highly considered.

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