Fibrous dysplasia of bone associated with primary hyperparathyroidism

Endocr Pract. 2013 Mar-Apr;19(2):226-30. doi: 10.4158/EP12301.OR.

Abstract

Objective: Fibrous dysplasia of bone and primary hyperparathyroidism (PHPT) may occur in patients with McCune-Albright Syndrome. A small number of cases with both diagnoses that are not associated with the above-mentioned genetic disorder have been published in the literature. It is uncertain if these disorders are linked in some way. In the present study, we aimed to further explore a potential relationship between PHPT and fibrous dysplasia of bone.

Methods: We conducted a retrospective review of all cases seen at Mayo Clinic, Rochester, Minnesota, between 1976 and 2011 that were diagnosed with both PHPT and fibrous dysplasia of bone.

Results: We identified 10 patients who were diagnosed with both PHPT and fibrous dysplasia of bone. Fibrous dysplasia was polyostotic in 7 (70%) cases. It affected the lower extremities in 6 (60%) patients, the skull or facial bones in 4 (40%), and was localized to one rib in 1 patient (10%). In 4 patients, fibrous dysplasia was diagnosed first, between 9 to 50 years before being diagnosed with PHPT. Two cases of fibrous dysplasia were recognized between 2 and 5 years after the diagnosis of PHPT. The remaining 4 patients were diagnosed with both conditions at approximately the same time.

Conclusion: It remains unclear if the association between fibrous dysplasia of bone and PHPT is more than coincidental, although the possibility of a rare familial genetic syndrome is not completely excluded.

MeSH terms

  • Adolescent
  • Adult
  • Bones of Lower Extremity
  • Calcium / blood
  • Child
  • Electronic Health Records
  • Facial Bones
  • Female
  • Fibrous Dysplasia of Bone / blood
  • Fibrous Dysplasia of Bone / complications*
  • Fibrous Dysplasia, Monostotic / blood
  • Fibrous Dysplasia, Monostotic / complications
  • Fibrous Dysplasia, Monostotic / epidemiology
  • Fibrous Dysplasia, Polyostotic / blood
  • Fibrous Dysplasia, Polyostotic / complications
  • Fibrous Dysplasia, Polyostotic / epidemiology
  • Humans
  • Hypercalcemia / etiology
  • Hyperparathyroidism, Primary / blood
  • Hyperparathyroidism, Primary / complications*
  • Hyperparathyroidism, Primary / physiopathology
  • Male
  • Minnesota / epidemiology
  • Parathyroid Hormone / blood
  • Phosphorus / blood
  • Retrospective Studies
  • Skull

Substances

  • PTH protein, human
  • Parathyroid Hormone
  • Phosphorus
  • Calcium