The purpose of this paper is to report on a patient who had two episodes of primary hyperparathyroidism separated by a 10-year asymptomatic period.
Report of a Case
A 35-year-old man was first admitted to the Duke University Medical Center on Sept. 19, 1945, for evaluation of pain in the back, ankles, and shoulders of two years' duration. He had also noted an enlarging, painful mass on the right clavicle for about one year. In the three years preceding this admission, he had experienced generalized weakness, anorexia, nausea, vomiting, epigastric pain, constipation, polyuria, polydipsia, photophobia, and a 10-lb. (4.5-kg.) weight loss. There was no history of renal colic.On physical examination the blood pressure was 140/95 mm. Hg, with otherwise normal vital signs. The only abnormal physical finding was a non-tender, 5-by-3-cm. bony mass in the right clavicle.The admission laboratory data included a hemoglobin level of 13 Gm.%, and