The woman had consulted a gynaecologist after noticing a lump during a self-breast examination. While a screening mammogram ruled out breast cancer, doctors discovered an unusual cystic swelling arising from the third rib. A subsequent chest X-ray suggested the lesion was a Brown Tumour, a rare bone manifestation associated with prolonged untreated hyperparathyroidism.
Further evaluation by the hospital's endocrine team, including a neck ultrasound and laboratory investigations, revealed a vascular left inferior parathyroid adenoma with significantly elevated calcium and parathyroid hormone (PTH) levels, confirming the diagnosis of Primary Hyperparathyroidism.
Doctors performed a left inferior parathyroidectomy, following which the patient's calcium levels returned to normal within three days. Histopathological examination confirmed the tumour was a benign parathyroid adenoma. The patient recovered well and was discharged on calcium supplements.
According to Dr. Sangeeta Jha, Senior Consultant – Surgical Endocrinologist at CARE Hospitals, Primary Hyperparathyroidism often remains undetected because many patients either have no symptoms or experience vague complaints that are easily overlooked.
"In this case, the diagnosis was made only because routine breast screening incidentally revealed an unusual rib lesion. Brown tumours are uncommon manifestations of prolonged hyperparathyroidism and can resemble breast, chest wall or bone diseases. Early diagnosis and timely surgery can prevent serious complications and significantly improve patient outcomes," she said.
Hospital Chief Operating Officer Abhinav Joshi said the case demonstrated the importance of coordinated care involving radiology, endocrinology, surgery and laboratory teams in identifying and treating complex medical conditions at an early stage.
Doctors noted that Primary Hyperparathyroidism is increasingly being detected during routine health check-ups before symptoms become severe. They advised people to seek medical evaluation if repeated blood tests show elevated calcium levels or if they experience recurrent kidney stones, unexplained osteoporosis, persistent bone pain, frequent fractures or unexplained fatigue.
Medical experts say timely diagnosis and surgical treatment can prevent irreversible bone damage and other complications associated with the disorder.