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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Tertiary hyperparathyroidism is due to excessive secretion of parathyroid hormones by hypertrophied parathyroid glands, usually after long-standing secondary hyperparathyroidism. When severe, it can rarely cause Brown tumours or Osteitis fibrosa cystica, which are non-malignant erosive bony lesions characterised by excessive bone resorption due to osteoclasts and remodelling by fibrous tissue. This is a rare case report of a patient with extensive Brown tumours requiring a challenging parathyroidectomy and the subsequent management of hungry bone syndrome.
A 23 year old woman on haemodialysis for 6 years had presented with progressively increasing swelling in her palate since 2 years, associated with difficulty in swallowing and speech. On examination, she was cachexic and had skeletal deformities in the form of kyphoscoliosis, pectus carinatum, splaying of teeth and short stature.
Blood investigations revealed hyperphosphatemia, high PTH and ALP levels indicating rapid bone turnover disease causing severe renal osteodystrophy. Whilst she was being worked up for parathyroidectomy, she had sustained a pathological fracture of her left humerus after a trivial injury and was hospitalised. She underwent skeletal screening in the form of CT imaging of skull, facial bones, neck, chest, abdomen & pelvis and whole spine, which showed classical findings of osteolytic bony lesions amd periosteal fibrosis.
In preparation for parathyroidectomy, the patient was loaded with alfacalcidol. She had bleeding from the oral mucosal tumours, putting her at high risk of aspiration and compromise of her precarious airways. Due to severe narrowing at the level of oro-nasopharynx with extensive Brown tumours in maxilla and mandible, both oral and nasal intubations were not feasible and a diligent anaesthetic airway management was drawn. She underwent subtotal parathyroidectomy (3/4 parathyroids removed) with awake mini-tracheostomy. As anticipated, she developed hungry bone syndrome in the post-operative period, necessitating intravenous calcium infusion. Hungry bone syndrome occurs due to an acute shift in bone metabolism after the removal of excess parathyroid hormone, causing increased osteoblastic activity and rapid consumption of calcium by the bones, resulting in severe hypocalcemia.
Successful and timely management of severe life-threatening tertiary hyperparathyroidism in this patient was made possible due to prompt diagnosis, seamless interprofessional collaboration between multi-disciplinary teams and meticulous pre and post-operative assessments & monitoring.
