{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T18:30:18Z","timestamp":1774290618873,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Primary hyperparathyroidism (PHPT) is commonly detected incidentally in high-income settings, but in resource-limited contexts it may still present with advanced skeletal disease. We report a 45-year-old woman with a seven-year history of progressive bone pain culminating in pathological fractures of the femoral neck and proximal humerus after minor trauma. Malignancy and myeloma were excluded by histology and hematologic work-up. Biochemistry showed severe hypercalcemia with strikingly elevated parathyroid hormone and alkaline phosphatase; imaging demonstrated diffuse osteopenia and localized enlarged parathyroid glands. She underwent parathyroidectomy with subsequent hungry bone syndrome, managed with calcium and vitamin D supplementation, followed by functional recovery and planned orthopedic fixation. This case highlights the risk of misdiagnosis where routine biochemical screening is limited, and emphasizes early consideration of metabolic bone disease in patients with unexplained fractures once malignancy is excluded.<\/jats:p>","DOI":"10.1093\/omcr\/omag023","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:43:06Z","timestamp":1774287786000},"source":"Crossref","is-referenced-by-count":0,"title":["Primary hyperparathyroidism presenting with pathological fractures mimicking malignancy: a case from Tanzania"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8836-3624","authenticated-orcid":false,"given":"Noorein","family":"Omar","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Muhimbili University of Health and Allied Sciences , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65001 ,","place":["Tanzania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9104-7778","authenticated-orcid":false,"given":"Lutfi","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Muhimbili University of Health and Allied Sciences , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65001 ,","place":["Tanzania"]},{"name":"Department of Internal Medicine, Muhimbili National Hospital , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65000 ,","place":["Tanzania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6984-3367","authenticated-orcid":false,"given":"Mahmoud","family":"Abeid","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Muhimbili University of Health and Allied Sciences , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65001 ,","place":["Tanzania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2747-2741","authenticated-orcid":false,"given":"Tareeq","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Muhimbili University of Health and Allied Sciences , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65001 ,","place":["Tanzania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0091-5496","authenticated-orcid":false,"given":"Mudhihir","family":"Rupia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Muhimbili University of Health and Allied Sciences , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65001 ,","place":["Tanzania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5209-2741","authenticated-orcid":false,"given":"Hilda","family":"Makungu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Muhimbili National Hospital , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65000 ,","place":["Tanzania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5100-2872","authenticated-orcid":false,"given":"Sibtain","family":"Moledina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Muhimbili University of Health and Allied Sciences , United Nations Road, Upanga West, Ilala District, Dar es Salaam, P.O. Box 65001 ,","place":["Tanzania"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"2026032313430460000_ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00198-016-3716-2","article-title":"Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus","volume":"28","author":"Khan","year":"2017","journal-title":"Osteoporos Int"},{"key":"2026032313430460000_ref2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"2026032313430460000_ref3","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/S0140-6736(17)31430-7","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian","year":"2018","journal-title":"Lancet"},{"key":"2026032313430460000_ref4","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1046\/j.0007-1323.2001.01775.x","article-title":"Unique clinical characteristics of primary hyperparathyroidism in India","volume":"88","author":"Mishra","year":"2001","journal-title":"Br J Surg"},{"key":"2026032313430460000_ref5","first-page":"184","article-title":"Primary hyperparathyroidism: update on presentation, diagnosis, and management in primary care","volume":"57","author":"Pallan","year":"2011","journal-title":"Can Fam Physician"},{"key":"2026032313430460000_ref6","doi-asserted-by":"publisher","first-page":"2036","DOI":"10.1210\/jcem.81.6.8964825","article-title":"Evaluation and management of primary hyperparathyroidism","volume":"81","author":"Silverberg","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2026032313430460000_ref7","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/S0196-0709(96)90075-7","article-title":"Brown tumor of the mandible","volume":"17","author":"Keyser","year":"1996","journal-title":"Am J Otolaryngol"},{"key":"2026032313430460000_ref8","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1590\/S0004-27302013000600002","article-title":"Diagnosis and management of primary hyperparathyroidism\u2014a scientific statement from the Department of Bone Metabolism, the Brazilian Society for Endocrinology and metabolism","volume":"57","author":"Bandeira","year":"2013","journal-title":"Arq Bras Endocrinol Metabol"},{"key":"2026032313430460000_ref9","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1172\/JCI11296","article-title":"Activated parathyroid hormone\/parathyroid hormone-related protein receptor in osteoblastic cells differentially affects cortical and trabecular bone","volume":"107","author":"Calvi","year":"2001","journal-title":"J Clin Invest"},{"key":"2026032313430460000_ref10","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1007\/BF01655425","article-title":"Psychiatric morbidity in primary hyperparathyroidism","volume":"12","author":"Joborn","year":"1988","journal-title":"World J Surg"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/3\/omag023\/67483603\/omag023.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/3\/omag023\/67483603\/omag023.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:43:08Z","timestamp":1774287788000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omag023\/8537681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,23]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omag023","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"omag023"}}