Possible relationship of primary hyperparathyroidism and fibrous dysplasia: report of case.

This report has considered the possibility that the described patient had a maxillary and possibly a mandibular fibrous dysplasia concomitant with a parathyroid abnormality. It has attempted to arouse the diagnostician's suspicion of possible interrelations of fibrous dysplasia and endocrine abnormalities, and to strengthen the hypothesis of others that association of fibrous dysplasia and hyperparathyroidism is not coincidental. Clinical, radiographic, and laboratory examinations more than a year postoperatively further substantiate our hypothesis that the patient had a facial fibrous dysplasia concomitant with primary hyperparathyroidism. The maxilla and mandible continued to enlarge clinically. Systemic manifestations of hyperparathyroidism had resolved. Calcium phosphorus, and parathyroid hormone levels returned to normal limits. Radiographically, there had been remodeling and recalcification of all involved bones except the maxilla and mandible which continued to expand. A possible explanation is that the maxillofacial lesions represent the polyostotic fibrous dysplasia component of the Albright syndrome. The endocrine abnormality could be manifested by the hyperparathyroidism. The third component of Albright syndrome, café au lait lesions, has not been identified. The potential interrelation of fibrous dysplasia with endocrine abnormalities is obviously important from a diagnostic and therapeutic standpoint. If there is more than a coincidental relationship-hereditary, hormonal, neurological, developmental, or any as-yet-unknown factor-only further research and studies will confirm or disprove it.