부갑상선 선종의 골병변과 이에 대한 치료

Abstract

Hyperparathyroidism is a rare clinical condition that may cause various musculoskeletal deformities and is usually caused by a parathyroid adenoma or parathyroid hyperplasia. Generalized osteoporosis was the basic manifestation seen in all of our cases. Pathologic fractures with bone deformities or brown tumors were observed in severe cases, which required a surgery in selected cases. The deformities caused by hyperparathyroidism mainly observed in the weight bearing lower extremities, usually manifested as coxa vara and /or genu valgum. Though the generalized osteoporosis could be improved after excision of parathyroid adenoma, skeletal deformities could not corrected by ablation of parathyroid adenoma, skeletal deformities could not corrected by ablation of parathyroid adenoma requiring some kind of corrective surgeries later. We have 7 cases of hyperparathyroidism caused by parathyroid adenoma between the period from 1971 to 1993. All of them were required surgical excision of the adenoma. Biomechanical changes were corrected within 4 weeks after parathyroid surgery. Osteoporosis even the brown tumors were improved gradually within a few years after parathyroid surgery but bone deformities were left uncorrected. In one case bilateral coxa vara and genu valgum deformities were severe enough to have corrective bone surgeries and this patient was followed up 5 and 7 years after corrective surgery.