{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:20:26Z","timestamp":1778070026524,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Pseudoaneurysmal bone cysts are rare complications of advanced primary hyperparathyroidism, mimicking malignant lesions or postoperative infections, particularly when accompanied by wound drainage and elevated inflammatory markers. A 49-year-old man underwent cemented total hip arthroplasty for a pathological femoral neck fracture. Persistent postoperative bloody-serous discharge and elevated infection markers such as C-reactive protein suggested early periprosthetic joint infection, prompting two surgical revisions. During both revision procedures, multiple deep tissue samples were obtained and sent for aerobic and anaerobic cultures with extended incubation as well as histopathological analysis. All microbiological cultures remained negative. Histopathology revealed a giant cell-rich, hemorrhagic, fibrous lesion consistent with a pseudoaneurysmal bone cyst due to undiagnosed primary hyperparathyroidism. Timely surgical debridement, microbiological sampling, and empiric antibiotics ensured patient safety while the metabolic etiology was being established. Biochemical tests confirmed hypercalcemia and elevated parathyroid hormone from a parathyroid adenoma. Primary hyperparathyroidism-induced osteoclastic activity can produce hemorrhagic cystic lesions resembling infection or malignancy. Meticulous surgical exploration, repeated microbiological sampling, and histopathological analysis excluded infection and malignancy, while definitive management via parathyroidectomy prevents further skeletal complications. This case emphasizes structured diagnostics and interdisciplinary orthopedic-endocrine collaboration for managing rare primary hyperparathyroidism complications effectively and underlines that persistent postoperative drainage with repeatedly negative cultures should prompt metabolic evaluation.<\/jats:p>","DOI":"10.1177\/2050313x261441736","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:45:59Z","timestamp":1777895159000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pseudoaneurysmal bone cyst secondary to primary hyperparathyroidism mimicking early infection following hip arthroplasty: A case report"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2111-4780","authenticated-orcid":false,"given":"Lennard M.","family":"Wurm","sequence":"first","affiliation":[{"name":"Department of Traumatology and Reconstructive Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Germany"},{"name":"Medical Faculty of Heinrich-Heine University and University Hospital D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"M\u00f6bius","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Reconstructive Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Neuhaus","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Reconstructive Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Ertel","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Reconstructive Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justyna","family":"Reinke","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Reconstructive Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"issue":"4","key":"e_1_3_2_2_2","article-title":"Primary hyperparathyroidism due to a giant parathyroid adenoma presenting with pathological fractures and multiple brown tumors","volume":"2024","author":"Meng J","year":"2024","unstructured":"Meng J, Aboznadah WM, Pusztaszeri M, et al. Primary hyperparathyroidism due to a giant parathyroid adenoma presenting with pathological fractures and multiple brown tumors. Endocrinol Diabetes Metab Case Rep 2024; 2024(4): e240054.","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04374-7"},{"key":"e_1_3_2_4_2","first-page":"321","article-title":"An unusual presentation of primary hyperparathyroidism: multiple brown tumors and coexisting thyroid carcinoma","volume":"35","author":"Basaran Y","year":"2016","unstructured":"Basaran Y, Ince S, Alagoz E, et al. An unusual presentation of primary hyperparathyroidism: multiple brown tumors and coexisting thyroid carcinoma. Rev Esp Med Nucl Imagen Mol 2016; 35: 321\u2013324.","journal-title":"Rev Esp Med Nucl Imagen Mol"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/03000605221123668"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.13107\/jocr.2024.v14.i01.4158"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2019.11.14"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1414896"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-022-00971-2"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjae520"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-018-1723-y"}],"container-title":["Sage Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X261441736","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X261441736","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X261441736","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:49:52Z","timestamp":1778068192000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X261441736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"alternative-id":["10.1177\/2050313X261441736"],"URL":"https:\/\/doi.org\/10.1177\/2050313x261441736","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"value":"2050-313X","type":"print"},{"value":"2050-313X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"2050313X261441736"}}