{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:37Z","timestamp":1756339417570,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,2,10]]},"abstract":"<jats:p>Primary hyperparathyroidism (PHPT) may lead to skeletal deformities, fractures and renal failure in symptomatic patients if untreated. We present a case of a 30-year-old woman presented with muscle weakness, weight loss, hypercalcaemia and a pathological fracture, eventually with rapidly progressive musculoskeletal disease. Subsequent biochemical, radiographic and scintigraphy findings were consistent with PHPT from an ectopic mediastinal adenoma, and concomitant vitamin D deficiency. The severe hypercalcaemia was adequately temporised with hydration, forced diuresis and intravenous bisphosphonates. Removal of the adenoma by video-assisted thoracoscopic surgery was contemplated; however, consent was withdrawn precluding histological confirmation. A review of literature shows the changing profiles of patients with PHPT, the uncommon occurrence of parathyroid adenomas in ectopic locations and possible association between severity of PHPT and vitamin D status.<\/jats:p>","DOI":"10.1136\/bcr-2014-203716","type":"journal-article","created":{"date-parts":[[2014,3,14]],"date-time":"2014-03-14T06:53:23Z","timestamp":1394780003000},"page":"bcr2014203716","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Primary hyperparathyroidism from a probable ectopic parathyroid adenoma with severe skeletal disease and vitamin D deficiency"],"prefix":"10.1136","volume":"2014","author":[{"given":"Carlo Jan P","family":"Garingarao","sequence":"first","affiliation":[{"name":"Department of Medicine; Section of Endocrinology, Diabetes and Metabolism, University of the Philippines, Philippine General Hospital, Manila, NCR, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Paz-Pacheco","sequence":"additional","affiliation":[{"name":"Department of Medicine; Section of Endocrinology, Diabetes and Metabolism, University of the Philippines, Philippine General Hospital, Manila, NCR, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia A","family":"Jimeno","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of the Philippines, College of Medicine, Manila, NCR, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,3,14]]},"reference":[{"key":"2025082702470251000_2014.mar14_1.bcr2014203716.1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026508829397"},{"key":"2025082702470251000_2014.mar14_1.bcr2014203716.2","first-page":"81","article-title":"Hyperparathyroidism: an early historical survey","volume":"51","author":"Rowlands","year":"1972","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082702470251000_2014.mar14_1.bcr2014203716.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2005.10.049"},{"key":"2025082702470251000_2014.mar14_1.bcr2014203716.4","doi-asserted-by":"publisher","DOI":"10.4158\/EP10052.OR"},{"key":"2025082702470251000_2014.mar14_1.bcr2014203716.5","doi-asserted-by":"crossref","first-page":"pii: bcr2012006198","DOI":"10.1136\/bcr-2012-006198","article-title":"Primary hyperparathyroidism due to an intrathyroidal parathyroid adenoma associated with chronic lymphocytic thyroiditis","volume":"2012","author":"Cating-Cabral","year":"2012","journal-title":"BMJ Case Rep"},{"key":"2025082702470251000_2014.mar14_1.bcr2014203716.6","doi-asserted-by":"crossref","unstructured":"Sandoval MS Paz-Pacheco E . Primary hyperparathyroidism with classic and severe skeletal involvement. BMJ Case Rep. 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