Reversal of the Histology of Bone After Parathyroidectomy in Patients With Hyperparathyroidism

ABSTRACT: Hyperparathyroidism is commonly seen in patients with end-stage renal disease  and less commonly in the primary form. The skeletal manifestations of hyperparathyroidism  are the same in both forms and are well described in the literature. We treated a patient from  each category. Multiple bony lesions and pathologic fractures were observed. The clinical  presentations and radiologic and histologic findings confirmed the diagnosis of  hyperparathyroidism and osteitis fibrosa cystica in both patients. Subtotal excisions of the  parathyroid glands were done in both patients. Appropriate treatment of the bony lesions and  pathologic fractures resulted in healing. Histologic evaluation of the bony lesions indicated an  osteoblastic or healing response. The reversal of the histologic pattern in just 5 days and 16  days after parathyroidectomy was noted. In treating such patients, physicians should consider  parathyroidectomy as an aid in the overall management of patients.