PMC6371999_01
A bone lesion measuring 71x30 mm (white arrow) on the proximal metaphysis of the left tibia and the other one measuring 87x44 mm in size (red arrow) in the distal metaphysis of the right femur are observed.
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F1
Radiograms revealed radiolucent bone lesions proximal to the left tibia and distal to the right femur and extensive decrease in bone densities (Fig. 1).
A bone lesion measuring 66x30 mm (white arrow) in the proximal metaphysis of the left tibia and the other one measuring 80x36 mm in the distal metaphysis of the right femur (red arrow) are observed.
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F2
Likewise, CT demonstrated expansile, hypodense bone lesions at a location proximal to the left tibia and distal to the right femur (Fig. 2, remarkable laboratory findings were as follows: calcium, 13.4 mg/dL (8.6-10 mg/dL); phosphorus, 2.22 mg/dL (2.6-4 mg/dL); alkaline phosphatase 636 IU/L (73-189 IU/L); 25-OH Vitamin D3 1.25 microg/L (10-55 microg/L), and PTH 1441 pg/mL (10-65 pg/mL).
Parathyroid adenoma-compatible lesion (white arrow) in the size of 11,5x5,5x19,5 mm is seen in the inferior lobe of the left thyroid gland.
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F3
In the neck US, a lesion compatible with parathyroid adenoma was observed near the lower left thyroid gland (Fig. 3).
Decreases in the dimensions of the Brown tumors localized in the tibia and femur are observed on the control knee radiograms.
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F4
The size of the lesions seen in the knee radiogram also decreased (Fig. 4).