primary hyperparathyroidism

Primary hyperparathyroidism is an important yet often overlooked cause of the chronic musculoskeletal pain. A delay in diagnosis may result in significant skeletal complications. We report a case of longstanding neglected back pain that ultimately led to the diagnosis of parathyroid adenoma. This case highlights the importance of considering metabolic causes in patients with persistent musculoskeletal symptoms and early evaluation to prevent irreversible complications.

Hungry bone syndrome (HBS) is characterized by persistent hypocalcemia and hypophosphatemia as a result of extensive remineralization following parathyroidectomy. It is a known but uncommon complication of parathyroid surgery, seen in 13–30% of cases. In this article, we report the case of a 36-year-old woman with increased thirst and polyuria as the first manifestation of primary hyperparathyroidism caused by an ectopic parathyroid adenoma located in the anterior mediastinum. After a single-port Thoracoscopic parathyroidectomy, the patient presented clinical signs of hypocalcemia consistent with hungry bone syndrome. This report highlights the diagnostic approach, surgical management, and postoperative care, emphasizing the importance of early recognition and intervention.